STEPHANIE VAN DINE


Address: 6070 Lakeside Commons Dr, Macon, GA 31210-5778
Phone: 4782542644

STEPHANIE VAN DINE (NPI# 1588153498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588153498
Entity Type Individual
Full Name STEPHANIE VAN DINE
Practice Address 6070 Lakeside Commons Dr
Macon
GA 31210-5778
Mailing Address 406 High Point Rd Nw
Milledgeville
GA 31061-7068
Practice Telephone 4782542644
Mailing Telephone 2563109987
Enumeration Date 2018-05-07
Last Update Date 2018-05-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
RN275921 GA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 6070 LAKESIDE COMMONS DR
City MACON
State GA
Zip Code 31210-5778

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548265549 Rallie D Cogburn Sr. Physician Assistant 6070 Lakeside Commons Dr, Macon, GA 31210-5778 2005-06-16
1194350546 Serwah Sarponma Amponsah Nurse Practitioner 6070 Lakeside Commons Dr, Macon, GA 31210-5778 2020-03-05
1336791292 Morgan Dowd Nurse Practitioner 6070 Lakeside Commons Dr, Macon, GA 31210-5778 2019-07-11
1740849082 Heather Hall Nurse Practitioner 6070 Lakeside Commons Dr, Macon, GA 31210-5778 2019-06-11
1598028060 Susannah Burns Goodman Nurse Practitioner 6070 Lakeside Commons Dr, Macon, GA 31210-5778 2012-06-20
1205113057 Middle Georgia Heart and Vascular Center, LLC Internal Medicine 6070 Lakeside Commons Dr, Macon, GA 31210-5778 2011-11-08
1376873513 Angela Rhea Ballard Physician Assistant 6070 Lakeside Commons Dr, Macon, GA 31210 2010-01-11
1962650440 Olexandr V. Smolensky Internal Medicine 6070 Lakeside Commons Dr, Macon, GA 31210-5778 2008-09-08
1922007541 William Douglas Knopf Internal Medicine 6070 Lakeside Commons Dr, Macon, GA 31210-5778 2005-07-15

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1033743455 Dana Elizabeth Toth Nurse Practitioner 5300 Bowman Rd, Macon, GA 31210 2020-02-25
1871124735 Jessica Bello Nurse Practitioner 5300 Bowman Road, Macon, GA 31210 2020-01-30
1225505787 Rebekah Hollinshead Occupational Therapist Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 2018-11-01
1346744943 Ace Medical Transport LLC. Ambulance 728 Gay Dr, Macon, GA 31210 2018-03-20
1972965226 Omar Faruk Ahmad Family Medicine 3400 Riverside Drvie, Macon, GA 31210 2016-03-25
1083074868 Macon Dentist Office, PC Dentist 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 2016-03-07
1992176952 Kerisia Wasztyl Marriage & Family Therapist 4691 Pine Valley Dr, Macon, GA 31210 2015-10-15
1073905444 Eunice Malave De Leon Social Worker 174 Spring St, Macon, GA 31210 2015-02-23
1396141545 Axis Surgery Center LLC Clinic/Center 230 Sheraton Blvd, Ste B, Macon, GA 31210 2014-11-17
1073914115 Monique Rechelle Delay Moore Community/Behavioral Health 646 Millrun Court, Macon, GA 31210 2014-09-09
Find all providers in zip 31210

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093315848 Tracy Tarvers Nurse Practitioner 129 Wolf Creek Dr N, Macon, GA 31210-9002 2020-10-30
1578160560 Ida Mayaka Nurse Practitioner 210 Autumn Trace Ct, Macon, GA 31210-8025 2020-10-03
1427664465 Shanna Lynn Beaulieu Nurse Practitioner 781 Spring St Ste 230, Macon, GA 31201-2185 2020-09-16
1467070557 Raquel Simmons Nurse Practitioner 670 Ivy Brook Way, Macon, GA 31210-5520 2020-07-06
1174159800 Jamie K Polk Nurse Practitioner 3951 Ridge Ave Ste C, Macon, GA 31210-5064 2020-03-13
1033743455 Dana Elizabeth Toth Nurse Practitioner 5300 Bowman Rd, Macon, GA 31210 2020-02-25
1730730581 Lindsay Fernandez Nurse Practitioner 102 Saint Johns Pl, Macon, GA 31210-8606 2019-09-24
1003468240 Skylar Nelson Nurse Practitioner 330 Hospital Dr Ste 200, Macon, GA 31217-8034 2019-07-09
1861051880 Courtney Elizabeth Avery Nurse Practitioner 540 Charter Blvd Ste 400, Macon, GA 31210-4882 2019-06-12
1376101196 Detra K Dixon Nurse Practitioner 227 Amalie Dr, Macon, GA 31220-2667 2019-06-05
Find all providers in MACON

Competitor

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City MACON
Zip Code 31210

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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