Provider Demographics
NPI:1174896989
Name:STEIN, MEREDITH SUE (CNM, WHNP-BC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:SUE
Last Name:STEIN
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:SUE
Other - Last Name:ANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:485 HURFFVILLE CROSSKEYS RD
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9369
Mailing Address - Country:US
Mailing Address - Phone:856-557-7530
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:1 WEST GATES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-662-2730
Practice Address - Fax:215-349-5224
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010265363LW0102X, 367A00000X
NJ25ME00075001367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health