Stephanie Stichter, ATC
Individual provider Active NPI Athletic Trainer · Culver, IN
NPI 1033624499 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1033624499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 36002029A (IN)
- Practice address
- 701 School St
Culver, IN 46511-1026 - Phone
- (574) 354-0099
- NPI assigned
- Dec 7, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36002029A | IN | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36002029A | IN | Yes |
Addresses
Primary practice location
701 School St
Culver, IN 46511-1026
Mailing address
1455 Holloway Dr
Plymouth, IN 46563-3177
Phone (574) 354-0099
Other practice location 1
1455 Holloway Dr
Plymouth, IN 46563-3177
Phone (574) 354-0099
Other providers in Culver, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.