Provider Demographics
NPI:1790065738
Name:STEPHENSON, CAMERON (NP)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5098
Mailing Address - Country:US
Mailing Address - Phone:615-920-7906
Mailing Address - Fax:615-920-8775
Practice Address - Street 1:196 BEVINS LN
Practice Address - Street 2:SUITE F
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8534
Practice Address - Country:US
Practice Address - Phone:502-863-2818
Practice Address - Fax:502-863-2764
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2017-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3009120363LP0200X
TN178734363LP0200X
AL1-132527363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics