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General NPI Number Information
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NPI Number | 1053139907
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Entity Type | Individual
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Provider Name | CARMEN MICHELLE STEPHENSON NP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 3640 HIGH ST STE 2E
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City | PORTSMOUTH
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State | VA
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Zip | 23707-3213
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Country | US
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Telephone | 757-215-3565
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Fax | 757-397-8026
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Provider Business Mailing Address
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Address Line | PO BOX 639971
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City | CINCINNATI
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State | OH
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Zip | 45263-9971
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024192104
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1168767
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License Number State | TX
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