Provider Demographics
NPI:1053765347
Name:VARNER, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:VARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GALE BLVD
Mailing Address - Street 2:1
Mailing Address - City:MELVINDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48122-1774
Mailing Address - Country:US
Mailing Address - Phone:313-948-8785
Mailing Address - Fax:
Practice Address - Street 1:50 GALE BLVD
Practice Address - Street 2:1
Practice Address - City:MELVINDALE
Practice Address - State:MI
Practice Address - Zip Code:48122-1774
Practice Address - Country:US
Practice Address - Phone:313-948-8785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other