Provider Demographics
NPI:1790427631
Name:STEPHENS-VASSER, KAREN FELICIA (NP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:FELICIA
Last Name:STEPHENS-VASSER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 KALA DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-3248
Mailing Address - Country:US
Mailing Address - Phone:770-875-6400
Mailing Address - Fax:
Practice Address - Street 1:2617 SANDY PLAINS RD STE 1204B
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-4213
Practice Address - Country:US
Practice Address - Phone:470-746-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN153985363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health