Provider Demographics
NPI:1255106621
Name:STEPHENS, ALEATHA CHANTEL
Entity type:Individual
Prefix:
First Name:ALEATHA
Middle Name:CHANTEL
Last Name:STEPHENS
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 1:3324 HANNA AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-6444
Mailing Address - Country:US
Mailing Address - Phone:513-570-9371
Mailing Address - Fax:
Practice Address - Street 1:3324 HANNA AVE APT 10
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-6444
Practice Address - Country:US
Practice Address - Phone:513-570-9371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide