Provider Demographics
NPI:1699211037
Name:CAGE, STEPHANIE M
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:M
Last Name:CAGE
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 1:1632 TURTLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2778
Mailing Address - Country:US
Mailing Address - Phone:580-647-9241
Mailing Address - Fax:
Practice Address - Street 1:1632 TURTLE POINT DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2778
Practice Address - Country:US
Practice Address - Phone:580-647-9241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172A00000XOther Service ProvidersDriver