Provider Demographics
NPI:1861915019
Name:FLUHARTY, STEPHANIE JEAN (FNP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JEAN
Last Name:FLUHARTY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:JEAN
Other - Last Name:HINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 763
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-0763
Mailing Address - Country:US
Mailing Address - Phone:800-541-4009
Mailing Address - Fax:
Practice Address - Street 1:1511 JOHNSON AVE STE 104
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1016
Practice Address - Country:US
Practice Address - Phone:681-342-3700
Practice Address - Fax:304-848-0705
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV89015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily