Provider Demographics
NPI:1326690132
Name:STEPHENS, PAULA SUZANNE (APRN)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:SUZANNE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:SUZANNE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2708 S RIFE MEDICAL LN STE 140
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1455
Mailing Address - Country:US
Mailing Address - Phone:479-338-3720
Mailing Address - Fax:479-338-3749
Practice Address - Street 1:2708 S RIFE MEDICAL LN STE 140
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758
Practice Address - Country:US
Practice Address - Phone:479-338-3720
Practice Address - Fax:479-338-3749
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR121401207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery