Provider Demographics
NPI:1598812943
Name:STEPHENSON, VICTORIA LYNNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LYNNE
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:LEECHBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15656-1243
Mailing Address - Country:US
Mailing Address - Phone:724-845-7252
Mailing Address - Fax:
Practice Address - Street 1:300 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-2416
Practice Address - Country:US
Practice Address - Phone:724-543-2941
Practice Address - Fax:724-548-8119
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN063501L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse