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NPI Code Detail

MEDICARE: KALEIGH MARIE STEPHENSON FNP-C

MEDICARE: KALEIGH MARIE STEPHENSON FNP-C
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
1363LF0000XFamily Nurse Practitioner213833LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1008174503OTHERLALOUISIANA STATE DRIVERS LIC

General Provider Information

NPI Number : 1336764604
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALEIGH MARIE STEPHENSON FNP-C
Provider Business Mailing Address
First Line : 102 S MONROE ST STE B
Second Line :
City : MINDEN
State : LA
Zip : 71055-3357
Country : US
Telephone Number : 318-382-7290
Fax Number : 318-382-7292
Provider Business Practice Location Address
First Line : 102 S MONROE ST STE B
Second Line :
City : MINDEN
State : LA
Zip : 71055-3357
Country : US
Telephone Number : 318-382-7290
Fax Number : 318-382-7292
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2020
Last Update Date : 06/12/2020

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Directions to “ KALEIGH MARIE STEPHENSON FNP-C” Practice Location

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