Basic Information
| Provider Information | |||||||||
| NPI: | 1902193030 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEIN | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | JOSEPHINE | ||||||||
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| Credential: | CFNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 128 M ST NW | ||||||||
| Address2: | PERRY FAMILY HEALTH CENTER | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200011205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2026823840 | ||||||||
| FaxNumber: | 2026823854 | ||||||||
| Practice Location | |||||||||
| Address1: | 128 M ST NW | ||||||||
| Address2: | PERRY FAMILY HEALTH CENTER | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200011205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2026823840 | ||||||||
| FaxNumber: | 2026823854 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2011 | ||||||||
| LastUpdateDate: | 07/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN960599 | DC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.