Provider Demographics
NPI:1902464738
Name:BUHR, STEPHANIE LYN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYN
Last Name:BUHR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W MACARTHUR BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-4636
Mailing Address - Country:US
Mailing Address - Phone:770-503-5196
Mailing Address - Fax:
Practice Address - Street 1:1441 AVOCADO AVE STE 503
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7706
Practice Address - Country:US
Practice Address - Phone:949-718-9020
Practice Address - Fax:949-718-9040
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily