Healthcare Provider Details

I. General information

NPI: 1659241404
Provider Name (Legal Business Name): ADRIANNA NIKOLE STEPHENS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4199 GATEWAY BLVD
NEWBURGH IN
47630-8940
US

IV. Provider business mailing address

481 S SLED RUN
SANTA CLAUS IN
47579-6254
US

V. Phone/Fax

Practice location:
  • Phone: 812-842-4280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number28265872C
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number28265872A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: