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General NPI Number Information
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NPI Number | 1740654458
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Entity Type | Individual
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Provider Name | NICOLETTE STEPHENS FNP
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Gender | Female
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1200 S PINE ISLAND RD STE 250
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City | PLANTATION
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State | FL
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Zip | 33324-4459
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Country | US
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Telephone | 615-586-0662
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Fax | 615-235-1322
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Provider Business Mailing Address
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Address Line | 594 HIGHWAY 100
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City | CENTERVILLE
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State | TN
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Zip | 37033-1212
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Country | US
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Telephone | 615-586-0662
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Fax | 615-235-1322
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11039318
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0000020645
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License Number State | TN
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