Provider Demographics
NPI:1538779285
Name:SCALES, STEPHANIE (FNP-BC)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:
Last Name:SCALES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16302 DE LOZIER ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77040-2052
Mailing Address - Country:US
Mailing Address - Phone:216-287-3242
Mailing Address - Fax:
Practice Address - Street 1:9101 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2302
Practice Address - Country:US
Practice Address - Phone:281-859-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily