Provider Demographics
NPI:1578131595
Name:STEPHENS, CAMESHIA RICHELLE
Entity Type:Individual
Prefix:
First Name:CAMESHIA
Middle Name:RICHELLE
Last Name:STEPHENS
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 1:4101 DELAFIELD LN APT 9104
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-4422
Mailing Address - Country:US
Mailing Address - Phone:214-650-5804
Mailing Address - Fax:
Practice Address - Street 1:4101 DELAFIELD LN APT 9104
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-4422
Practice Address - Country:US
Practice Address - Phone:214-650-5804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider