Provider Demographics
NPI:1326297177
Name:BRASFIELD, STEPHANIE W (PT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:W
Last Name:BRASFIELD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2852
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38502-2852
Mailing Address - Country:US
Mailing Address - Phone:931-738-2221
Mailing Address - Fax:931-372-8679
Practice Address - Street 1:550 N SPRING ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1330
Practice Address - Country:US
Practice Address - Phone:931-837-2221
Practice Address - Fax:931-837-2782
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000003002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN446592Medicaid