Individual provider · Type 1 NPI
Stephanie G. Mishenko
Military Health Care Provider · Slc, UT
NPI number
1790396554
Active
Practice location
344E 100S
Slc, UT 84111
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military Health Care Provider Primary | 171000000X | None listed |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
About NPI 1790396554
Stephanie G. Mishenko's National Provider Identifier is 1790396554, issued on Aug 13, 2020. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Slc, UT. The record was last updated on Aug 13, 2020.