Basic Information
Provider Information
NPI: 1124670484
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHLESMAN
FirstName: STEPHANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2901 JOLLY RD
Address2:  
City: PLYMOUTH MEETING
State: PA
PostalCode: 194622324
CountryCode: US
TelephoneNumber: 6102728221
FaxNumber: 6102725655
Practice Location
Address1: 2901 JOLLY RD
Address2:  
City: PLYMOUTH MEETING
State: PA
PostalCode: 194622324
CountryCode: US
TelephoneNumber: 6102728221
FaxNumber: 6102725655
Other Information
ProviderEnumerationDate: 07/16/2019
LastUpdateDate: 07/23/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP2300XSP020541PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
163W00000XRN623946PAN Nursing Service ProvidersRegistered Nurse 

No ID Information.


Home