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General NPI Number Information
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NPI Number | 1063178671
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Entity Type | Individual
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Provider Name | STEFANI LYVETTE DENT
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Gender | Female
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 4425 MEMORIAL DR
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City | DECATUR
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State | GA
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Zip | 30032-1337
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Country | US
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Telephone | 404-298-8330
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 STANCIL ST
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4208
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Country | US
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Telephone | 757-502-9574
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC007198
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | GAA-NP001178
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 0001262756
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024185090
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License Number State | VA
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