Provider Demographics
NPI:1841720240
Name:SPEIGHTS-SELLERS, STEPHANIE L (APRN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:SPEIGHTS-SELLERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211699
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3699
Mailing Address - Country:US
Mailing Address - Phone:866-849-0692
Mailing Address - Fax:
Practice Address - Street 1:1055 HOWELL MILL RD NW FL 8
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-5557
Practice Address - Country:US
Practice Address - Phone:866-849-0692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3-002629363LF0000X
GAGAA-NP002943363LF0000X
WAAP60923346363LF0000X
SCF22478363LF0000X
COC-APN.0103384-C-NP363LF0000X
OR10050974363LF0000X
FLAPRN9278331363LF0000X
AZ281898363LF0000X
VA0024192309363LF0000X
IN71017436A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily