Healthcare Provider Details

I. General information

NPI: 1306709464
Provider Name (Legal Business Name): JANIE NICOLE STEPHENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 N PINE ST
NEWTON KS
67114-2719
US

IV. Provider business mailing address

919 N PINE ST
NEWTON KS
67114-2719
US

V. Phone/Fax

Practice location:
  • Phone: 316-706-0334
  • Fax:
Mailing address:
  • Phone: 316-706-0334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: