Provider Demographics
NPI:1629058128
Name:STEPHENS, TANYA (FNP-BC, NP-C)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:FNP-BC, NP-C
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:
Other - Last Name:BIVINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:225 OLENTANGY XING W
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1693
Mailing Address - Country:US
Mailing Address - Phone:401-662-7088
Mailing Address - Fax:
Practice Address - Street 1:1134 N MAIN ST STE 1300
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2381
Practice Address - Country:US
Practice Address - Phone:937-592-5015
Practice Address - Fax:937-592-0207
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029997363LF0000X
IL041.406177163W00000X
IL209.010150363LF0000X
ARA004279363LF0000X
MI4704232984163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse