Gracie, Stephanie

Gracie, Stephanie is an individual health care provider with primary practice located at 4683 Van Dyke Rd , Lutz FL 33558-4880. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Gracie, Stephanie can be contacted via phone (727) 686-9609.

Contact Information

Primary practice address
4683 Van Dyke Rd Lutz FL 33558-4880
Phone: (727) 686-9609
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9292259 Florida
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X ARNP9292259 Florida

Profile Details

NPI number 1295108322
LBN Legal business name Gracie, Stephanie
Credentials A.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2015
Last updated Sep 27th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295108322 NPPES
Florida Other 8WLBJ BLUE CROSS BLUE SHIELD
Florida MEDICAID 016194600 BLUE CROSS BLUE SHIELD

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