Healthcare Provider Details

I. General information

NPI: 1104577659
Provider Name (Legal Business Name): PAIGE STEPHENSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CENTER HILL DR BLDG II
OPELIKA AL
36801-6862
US

IV. Provider business mailing address

451 IVY PARK LN NE
ATLANTA GA
30342-4554
US

V. Phone/Fax

Practice location:
  • Phone: 334-742-2112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP249509
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-149864
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: