Provider Demographics
NPI:1508447699
Name:STEPHENSON, MERIDITH TAYLOR
Entity Type:Individual
Prefix:
First Name:MERIDITH
Middle Name:TAYLOR
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6502 NICHOLAS DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-7119
Mailing Address - Country:US
Mailing Address - Phone:806-220-7834
Mailing Address - Fax:
Practice Address - Street 1:2505 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1527
Practice Address - Country:US
Practice Address - Phone:806-282-3784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator