Provider Demographics
NPI:1902576143
Name:HALLENBECK, STEPHANIE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:HALLENBECK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:207 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1835
Mailing Address - Country:US
Mailing Address - Phone:603-895-3351
Mailing Address - Fax:603-895-0773
Practice Address - Street 1:128 ROUTE 27
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-1230
Practice Address - Country:US
Practice Address - Phone:603-895-3351
Practice Address - Fax:603-895-0773
Is Sole Proprietor?:No
Enumeration Date:2021-09-19
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH088380-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily