Provider Demographics
NPI:1447483318
Name:FOE, STEPHANIE ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ANN
Last Name:FOE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 ALFRED HARRELL HWY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-9651
Mailing Address - Country:US
Mailing Address - Phone:661-872-2545
Mailing Address - Fax:
Practice Address - Street 1:5900 ALFRED HARRELL HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-9651
Practice Address - Country:US
Practice Address - Phone:661-872-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA11092363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical