Provider Demographics
NPI:1689021693
Name:CHOI, STEPHANIE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE MARIE
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7326
Mailing Address - Country:US
Mailing Address - Phone:870-212-1500
Mailing Address - Fax:
Practice Address - Street 1:12 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7326
Practice Address - Country:US
Practice Address - Phone:870-212-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program