Provider Demographics
NPI:1174153407
Name:FARIO, STEFANIE LYN
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:LYN
Last Name:FARIO
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 1:26 TRANSOM RD
Mailing Address - Street 2:
Mailing Address - City:PORT WENTWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:31407-5602
Mailing Address - Country:US
Mailing Address - Phone:352-552-3235
Mailing Address - Fax:
Practice Address - Street 1:26 TRANSOM RD
Practice Address - Street 2:
Practice Address - City:PORT WENTWORTH
Practice Address - State:GA
Practice Address - Zip Code:31407-5602
Practice Address - Country:US
Practice Address - Phone:352-552-3235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-26
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175F00000XOther Service ProvidersNaturopath