Provider Demographics
NPI:1487947164
Name:CONVEY, STEPHANIE POWERS (RN/NP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:POWERS
Last Name:CONVEY
Suffix:
Gender:F
Credentials:RN/NP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LEIGH
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN/NP
Mailing Address - Street 1:269 UNION ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1314
Mailing Address - Country:US
Mailing Address - Phone:781-581-3900
Mailing Address - Fax:781-715-6232
Practice Address - Street 1:269 UNION ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1314
Practice Address - Country:US
Practice Address - Phone:781-581-3900
Practice Address - Fax:781-715-6232
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270935363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health