Provider Demographics
NPI:1821266487
Name:STEPHENS, STEPHANIE S (RN, MSN, WHNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:S
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:RN, MSN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 S INDEPENDENCE BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-4776
Mailing Address - Country:US
Mailing Address - Phone:757-471-6903
Mailing Address - Fax:
Practice Address - Street 1:2020 S INDEPENDENCE BLVD STE 5
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-4776
Practice Address - Country:US
Practice Address - Phone:757-471-6903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165372363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health