Provider Demographics
NPI:1780044941
Name:STEPHENS, DARLENE (RN)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5926 SUMMERSWEET DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45315-9796
Mailing Address - Country:US
Mailing Address - Phone:937-248-1456
Mailing Address - Fax:
Practice Address - Street 1:5926 SUMMERSWEET DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:OH
Practice Address - Zip Code:45315-9796
Practice Address - Country:US
Practice Address - Phone:937-248-1456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 398593163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse