Stefanie Matos Medina, CRNP
Nurse Practitioner, Family in Philadelphia, PA. Individual provider (NPI-1).
NPI number1104771682
StatusActive
Last updated in NPPESMar 2, 2026
Details
- NPI
- 1104771682
- Entity type
- Individual (NPI-1)
- Name
- Stefanie Matos Medina
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 2, 2026
- Certification date
- Mar 2, 2026
- Last updated
- Mar 2, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | SP035406 | PA | Yes |
Practice location
2981 Grant AvePhiladelphia, PA 19114-1024
Phone 215-632-4550 · Fax 215-632-7865
Mailing address
2106 Longview RdWarrington, PA 18976-1525
Phone 215-498-0085
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