1538498191 NPI number — CAROL ANN STEPHENSON DNP, RN, NP-C

Table of content: CAROL ANN STEPHENSON DNP, RN, NP-C (NPI 1538498191)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538498191 NPI number — CAROL ANN STEPHENSON DNP, RN, NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEPHENSON
Provider First Name:
CAROL
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP, RN, NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538498191
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12231 SOUTHMEADOW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAFFORD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77477-2229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-788-5313
Provider Business Mailing Address Fax Number:
281-240-6681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13111 EAST FWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77015-5803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-393-2127
Provider Business Practice Location Address Fax Number:
713-393-2714
Provider Enumeration Date:
12/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  AP117994 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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