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General NPI Number Information
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NPI Number | 1295626083
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Entity Type | Individual
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Provider Name | KIMBERLY E STEPHENS PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 2020 E CHESTNUT AVE
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City | VINELAND
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State | NJ
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Zip | 08361-8432
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Country | US
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Telephone | 856-563-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 807 N NEW ST
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City | CLAYTON
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State | NJ
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Zip | 08312-1202
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Country | US
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Telephone | 856-449-1087
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00914600
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License Number State | NJ
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