Provider Demographics
NPI:1144355702
Name:NICKMAN-TRIPLETT, STEPHANIE ANN (AUD)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANN
Last Name:NICKMAN-TRIPLETT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 NICKMANS PLAZA
Mailing Address - Street 2:
Mailing Address - City:LEMONT FURNACE
Mailing Address - State:PA
Mailing Address - Zip Code:15456
Mailing Address - Country:US
Mailing Address - Phone:724-437-3276
Mailing Address - Fax:724-438-7006
Practice Address - Street 1:8 NICKMANS PLAZA
Practice Address - Street 2:AUDIOLOGY & HEARING AID SERVICES
Practice Address - City:LEMONT FURNACE
Practice Address - State:PA
Practice Address - Zip Code:15456
Practice Address - Country:US
Practice Address - Phone:724-437-3276
Practice Address - Fax:724-438-7006
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000134L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1516060OtherGATEWAY
PA253093OtherBEST HEALTH CARE
PA1578697OtherBC BS MICHAGAN
PA1578697OtherSECURITY BLUE
PA319228OtherUPMC
PA1346369OtherUNITED MINE WORKERS
PA1578697OtherHIGHMARK SERVICE
PA231698OtherHEALTH AMERICA & ADVANTRA
PA1578697OtherPEBTF
PA524510OtherUS HEALTH CARE
PA01604OtherNATIONAL EAR CARE PLAN
PA149349OtherUNISON
PA1560582OtherUNITED HEALTH CARE
PA201674Medicaid
PA3432516OtherAETNA
PA1346369OtherUNITED MINE WORKERS