Provider Demographics
NPI:1114205275
Name:STEPHENSON, LORRAINE ANN (NP)
Entity Type:Individual
Prefix:PROF
First Name:LORRAINE
Middle Name:ANN
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E NORTHFIELD RD STE 1D
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4800
Mailing Address - Country:US
Mailing Address - Phone:862-223-8449
Mailing Address - Fax:866-755-9171
Practice Address - Street 1:315 E NORTHFIELD RD STE 1D
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4800
Practice Address - Country:US
Practice Address - Phone:862-223-8449
Practice Address - Fax:866-755-9171
Is Sole Proprietor?:No
Enumeration Date:2011-07-23
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305925363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health