MEDICARE: BERKLEY MARIE STEPHENS WHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	1018544	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629671961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERKLEY MARIE STEPHENS WHNP-BC

Provider Business Mailing Address
First Line	:	5200 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7709
Country	:	US
Telephone Number	:	214-590-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9301 N CENTRAL EXPRESSWAY TOWER 2 SUITE 560
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231
Country	:	US
Telephone Number	:	972-332-0215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	04/06/2026

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