KING STEPHANIE GWEN

Debarred entity

Born 7 Jul 1976 (50 years old),United States. Named in 5 sanctions listings.

Screen this subject

Summary

License number: PROMISe#: 102633730

Sanctions and listings5

Effective
25 Mar 2020
Official designation
Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded
pa.gov
Effective
20 Jul 2023
Official designation
Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded
pa.gov
Effective
20 Jul 2023
Official designation
Pennsylvania Department of Human ServicesUS Delaware Medicaid Sanctioned ProvidersUnited States
medicaid.dhss.delaware.gov
Effective
20 Jul 2023
Official designation
New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States
omig.ny.gov
Effective
20 Jul 2023
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128a1
Programme US-HHS-OIGoig.hhs.gov oig.hhs.gov

Positions held2

Period not retained
NURSE/NURSES AIDE (IND- LIC HC SERV PRO)
Period not retained
RN/CRNP

Identifiers4

Identifier	Number
ID number	SP011532/ RN554209
ID number	SP011532; RN554209
ID number	00401898
NPI number	1518246669

Other names3

Also known as3

Stephanie Gwen KingStephanie G. KingStephanie G King

Addresses2

6860 SHESHEQUIN ROAD, ULSTER, PA 18850
Bradford, PA

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