Provider Demographics
NPI:1396930673
Name:MAYFIELD, STEPHANIE D (NNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:D
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 ALCOA HWY
Mailing Address - Street 2:SUITE 145
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1500
Mailing Address - Country:US
Mailing Address - Phone:865-582-3123
Mailing Address - Fax:865-305-5857
Practice Address - Street 1:1930 ALCOA HWY
Practice Address - Street 2:SUITE 145
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1500
Practice Address - Country:US
Practice Address - Phone:865-544-6650
Practice Address - Fax:865-544-6572
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN128822080N0001X
TN145975163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No163WP0200XNursing Service ProvidersRegistered NursePediatrics