Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 95017541 | CA |
NPI | 1023786340 |
---|---|
Provider Name | Christine Stephens |
First Address | Clovis, CA 93611-4434 |
Second Address | Clovis, CA 93611-4434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2021 |
Last Update Date | 01/09/2021 |