Healthcare Provider Details

I. General information

NPI: 1154388072
Provider Name (Legal Business Name): LONE BIRGIT STEPHENS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

I-15 EXIT 9 AT THE FIRESTATION
LITTLEFIELD AZ
86432-0490
US

IV. Provider business mailing address

PO BOX 1625
PAGE AZ
86040-1625
US

V. Phone/Fax

Practice location:
  • Phone: 928-347-5971
  • Fax: 928-347-5793
Mailing address:
  • Phone: 928-645-9675
  • Fax: 928-645-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3424
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number104953-1206
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number657
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: