Provider Demographics
NPI:1356848444
Name:MUELLER, STEPHANIE LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8665 REBA LN
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-2326
Mailing Address - Country:US
Mailing Address - Phone:618-225-7253
Mailing Address - Fax:
Practice Address - Street 1:7693 RHEA COUNTY HWY STE 1
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-6083
Practice Address - Country:US
Practice Address - Phone:423-594-8700
Practice Address - Fax:423-594-0788
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN62161208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ041932Medicaid