Provider Demographics
NPI:1356489611
Name:STEBBINS, JACQUELINE IRENE (RN)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:IRENE
Last Name:STEBBINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:JACQUELINE
Other - Middle Name:IRENE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 9054
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-9054
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3696
Practice Address - Street 1:ROUTE 3 BOX 1700
Practice Address - Street 2:LEE COUNTY BEHAVIORAL HEALTH SERVICES
Practice Address - City:JONESVILLE
Practice Address - State:VA
Practice Address - Zip Code:24263
Practice Address - Country:US
Practice Address - Phone:276-346-3590
Practice Address - Fax:276-346-3612
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001195883163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse