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NPI Code Detail

MEDICARE: MS. JODI-ANN D STEPHENSON LPN

MEDICARE: MS. JODI-ANN D STEPHENSON LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse805861NY

General Provider Information

NPI Number : 1154661510
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JODI-ANN D STEPHENSON LPN
Provider Business Mailing Address
First Line : 3912 LACONIA AVE # 2
Second Line :
City : BRONX
State : NY
Zip : 10466-4906
Country : US
Telephone Number : 347-346-2872
Fax Number :
Provider Business Practice Location Address
First Line : 3912 LACONIA AVE # 2
Second Line :
City : BRONX
State : NY
Zip : 10466-4906
Country : US
Telephone Number : 347-346-2872
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2013
Last Update Date : 11/17/2020

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