Healthcare Provider Details

I. General information

NPI: 1326969403
Provider Name (Legal Business Name): DANIELLE STEPHENS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PROGRESS WAY
OWENTON KY
40359-6032
US

IV. Provider business mailing address

120 PROGRESS WAY
OWENTON KY
40359-6032
US

V. Phone/Fax

Practice location:
  • Phone: 502-484-2117
  • Fax:
Mailing address:
  • Phone: 502-484-2117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4061552
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: