Healthcare Provider Details

I. General information

NPI: 1558935726
Provider Name (Legal Business Name): STEPHANIE LYNN ALLEN-WINTERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

469 GARLAND ST
MEMPHIS TN
38104-7026
US

IV. Provider business mailing address

469 GARLAND ST
MEMPHIS TN
38104-7026
US

V. Phone/Fax

Practice location:
  • Phone: 901-461-4857
  • Fax:
Mailing address:
  • Phone: 901-461-4857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35543
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number72706
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: