Provider Demographics
NPI:1659467686
Name:STOKES, STEPHEN D (CRNA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:STOKES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 BAYOU BOULEVARD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503
Mailing Address - Country:US
Mailing Address - Phone:850-477-8109
Mailing Address - Fax:850-478-2412
Practice Address - Street 1:4810 NORTH DAVIS HIGHWAY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503
Practice Address - Country:US
Practice Address - Phone:850-474-8988
Practice Address - Fax:850-476-5312
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3160972367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00189757OtherRAILROAD MEDICARE
FLG2255OtherBCBS OF FLORIDA
FLE0064VMedicare PIN