| Provider / Organization | NPI | Date Certified |
|---|---|---|
| STEPHEN DOUGLAS DEPP | 1851900864 | 2020-07-26 |
Stephen Douglas Depp [M] graduated in 2020 and primarily specializes in Nurse Practitioner.
Stephen Douglas Depp is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1851900864. Registration indicates Stephen Douglas Depp is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Acute Care, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Acute Care, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 6608294988 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Stephen Douglas Depp |
| Practice Office Address | 1000 E WASHINGTON ST MEDINA, OH US |
| Practice Office Telephone | 3307251000 |
| Mailing Address | 9500 EUCLID AVE CLEVELAND, OH 441950002 US |
| Business Telephone | 2164442200 |
| Code | Practice | License No State |
|---|---|---|
| 363LA2100X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Acute Care All Other Specialties & Provider Types Nurse Practitioner Acute Care Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | APRN.CNP0027210
OH |