Stefanie M Patrick, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

256196 Issued in AZ

Practice address

2240 Winrow Rd BLDG 45001
Fort Huachuca, AZ 85613-5080

Phone

(520) 533-9033

Fax

(520) 833-5328

NPI assigned

Sep 19, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635552000000",
    "number": "1396264636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 WINROW RD BLDG 45001",
            "city": "FORT HUACHUCA",
            "state": "AZ",
            "postal_code": "856135080",
            "telephone_number": "520-533-9033",
            "fax_number": "520-533-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 WINROW RD BLDG 45001",
            "city": "FORT HUACHUCA",
            "state": "AZ",
            "postal_code": "856135080",
            "telephone_number": "520-533-9033",
            "fax_number": "520-833-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "STEFANIE",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2021-10-30",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0017143899",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "256196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van Nhan Nguyen, RN, FNP-BC
• Michael Patrick Nolan, PHARM.D
• Tyler H Norton, PT, DPT
• Olymphia O'Neale-White, LCSW
• Jason Patrick, FNP-C
• Kai Pedersen, DMD
• Ritzie Miguel Perez
• Virginia Mary Perry, LPN
• Gail Pielack, FNP-C
• Kari Francine Pink, AUD

• Family Nurse Practitioner in Fort Huachuca, AZ
• Providers in Fort Huachuca, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.