Provider Demographics
NPI:1295782357
Name:STEPHENSON, YVONNE (RN, CRNP)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3129 FOX VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WEST FRIENDSHIP
Mailing Address - State:MD
Mailing Address - Zip Code:21794-9543
Mailing Address - Country:US
Mailing Address - Phone:410-489-4086
Mailing Address - Fax:
Practice Address - Street 1:7200 3RD AVE
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-5201
Practice Address - Country:US
Practice Address - Phone:410-795-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR127603363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S99235Medicare UPIN