Healthcare Provider Details

I. General information

NPI: 1710843412
Provider Name (Legal Business Name): VANESSA LYNN STEPHENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2025
Last Update Date: 12/27/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 GORDLEY RD
PEEBLES OH
45660-9138
US

IV. Provider business mailing address

31 GORDLEY RD
PEEBLES OH
45660-9138
US

V. Phone/Fax

Practice location:
  • Phone: 937-779-0618
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: