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General NPI Number Information
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NPI Number | 1144171224
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Entity Type | Individual
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Provider Name | TYLER LEWIS STEPHENSON NURSE PRACTITIONER
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Gender | Male
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 812 AMHERST ST STE 101
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City | WINCHESTER
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State | VA
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Zip | 22601-3344
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Country | US
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Telephone | 540-722-0220
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Fax | 540-722-0191
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Provider Business Mailing Address
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Address Line | 115 KEENS CIRCLE APT. # 401
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City | WINCHESTER
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State | VA
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Zip | 22602
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Country | US
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Telephone | 276-781-3427
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0024196258
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License Number State | VA
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