Provider Demographics
NPI:1043764467
Name:TEUBNER, STEPHANIE L (PMHNP, RN)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:L
Last Name:TEUBNER
Suffix:
Gender:F
Credentials:PMHNP, RN
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:MCCRACKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1701 W SAINT MARYS RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2621
Mailing Address - Country:US
Mailing Address - Phone:520-628-8287
Mailing Address - Fax:
Practice Address - Street 1:1701 W SAINT MARYS RD
Practice Address - Street 2:SUITE 160
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2621
Practice Address - Country:US
Practice Address - Phone:520-628-8287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8835363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health