MEDICARE: DR. ELIZABETH ANN STEPHENSON AP

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
1	171100000X	Acupuncturist	AP 2861	FL

General Provider Information

NPI Number	:	1497067797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH ANN STEPHENSON AP

Provider Business Mailing Address
First Line	:	1119 MEDITATION LOOP
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-5015
Country	:	US
Telephone Number	:	386-334-3231
Fax Number	:

Provider Business Practice Location Address
First Line	:	1893 N CLYDE MORRIS BLVD
Second Line	:	SUITE 110
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5535
Country	:	US
Telephone Number	:	386-334-3231
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2010
Last Update Date	:	07/02/2010

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