Provider Demographics
NPI:1538498191
Name:STEPHENSON, CAROL ANN (DNP, RN, NP-C)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:DNP, RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12231 SOUTHMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2229
Mailing Address - Country:US
Mailing Address - Phone:281-788-5313
Mailing Address - Fax:281-240-6681
Practice Address - Street 1:13111 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5803
Practice Address - Country:US
Practice Address - Phone:713-393-2127
Practice Address - Fax:713-393-2714
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117994363L00000X
TX551920363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner