Provider Demographics
NPI:1629385901
Name:STEPHENS, DAVID R (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:3373 COMMERCE PKWY
Mailing Address - Street 2:STE 3
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7130
Mailing Address - Country:US
Mailing Address - Phone:330-439-4656
Mailing Address - Fax:330-601-0081
Practice Address - Street 1:875 8TH ST NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-8503
Practice Address - Country:US
Practice Address - Phone:330-834-4788
Practice Address - Fax:330-834-4789
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2020-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHRN327644367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered