SHANE STEPHENS


Address: 1025 Executive Park Blvd, Kingsport, TN 37660-4620
Phone: 8333707433

SHANE STEPHENS (NPI# 1285117606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285117606
Entity Type Individual
Full Name SHANE STEPHENS
Practice Address 1025 Executive Park Blvd
Kingsport
TN 37660-4620
Mailing Address 7032 Robinette Valley Rd
Duffield
VA 24244-2979
Practice Telephone 8333707433
Mailing Telephone 8285515679
Enumeration Date 2018-09-11
Last Update Date 2018-09-11
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
24695 TN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1025 EXECUTIVE PARK BLVD
City KINGSPORT
State TN
Zip Code 37660-4620

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174038749 Sbh-kingsport Psychiatric Hospital 1025 Executive Park Blvd, Kingsport, TN 37660 2017-12-05
1205443058 Clinton Davis Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2020-09-25
1063021087 Leslie Renee Trivett Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2020-07-27
1114543642 Phillip Connors Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2020-06-20
1477103661 Mary Evans Social Worker 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2019-09-19
1063065621 Stefani Ellis Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2019-07-22
1245798107 Kelly Hyder Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2019-03-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1750909891 Nancy Gober Pharmacist Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 2020-07-06
1700437621 Tammy Denise Leblanc Technician 125 Lancer Rd, Kingsport, TN 37660 2019-09-23
1831743392 Independent Physical Therapy Occupational Therapist 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 2019-08-01
1871095315 Macie Anderson Nurse Practitioner 411 Clay St, Kingsport, TN 37660 2018-03-01
1053813527 Pulitzer Orthodontics, LLC Dentist 1200 Pulitzer Place, Kingsport, TN 37660 2018-03-01
1548771447 Sara B Ball Registered Nurse 111 W Stone Dr Ste 240, Kingsport, TN 37660 2017-10-18
1821525361 Ashley Brook Weems Nurse Practitioner Six Sheridan Square Suite 100, Kingsport, TN 37660 2017-05-15
1639625643 Stephanie H Garris Nurse Practitioner 117 W Sevier Ave Ste 120, Kingsport, TN 37660 2016-08-30
1073965679 Teresa Anne Starke Physician Assistant 8 Sheridan Square, Suite 110, Kingsport, TN 37660 2016-07-07
1316323231 Alexandra Rebecca Mccracken Speech-Language Pathologist 301 Louis St. #101, Mountain Region Speech & Hearing Center, Kingsport, TN 37660 2015-08-03
Find all providers in zip 37660

Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659972966 Rebecca Singleton Nurse Practitioner 2601 N John B Dennis Hwy Apt 2318, Kingsport, TN 37660-0835 2020-11-03
1205443058 Clinton Davis Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2020-09-25
1063021087 Leslie Renee Trivett Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2020-07-27
1114543642 Phillip Connors Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2020-06-20
1063065621 Stefani Ellis Nurse Practitioner 1025 Executive Park Blvd, Kingsport, TN 37660-4620 2019-07-22
1558569426 Joan Colette D'cruz Nurse Practitioner 1944 Brookside Dr, Suite 1, Kingsport, TN 37660-4618 2007-07-03
1730230681 Maureen A Gaynor Nurse Practitioner 1570 Waverly Rd, Kingsport, TN 37664-2523 2007-01-16
1851304604 Ashley Taylor Nurse Practitioner 2300 Pavilion Dr, Kingsport, TN 37660-4622 2006-08-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1205434503 Sonya Lavet Butler Nurse Practitioner 3413 Axelwood Dr, Murfreesboro, TN 37128-3984 2020-10-09
1417554361 John Pearson Redmond Nurse Practitioner 1710 Ghost Creek Dr, Collierville, TN 38017-3425 2020-10-05
1861099061 Justin Mccord Nurse Practitioner 454 Red Hill Center Rd, Lawrenceburg, TN 38464-6842 2020-10-01
1265049977 Toya Owens Nurse Practitioner 2565 Mackinnon Dr, Memphis, TN 38119-7903 2020-09-26
1043827041 Zamaria Davion Louise Gains Nurse Practitioner 7405 Shallowford Rd Ste 230, Chattanooga, TN 37421-7632 2020-09-24
1376158998 Mary L Dean Turner Nurse Practitioner 6727 Stonetrace Dr, Bartlett, TN 38135-3054 2020-09-10
1205447794 Sana Pathan Nurse Practitioner 829 S Sherbrooke Cir, Mount Carmel, TN 37645-4019 2020-08-10
1093325557 Highland Behavioral Healthcare Nurse Practitioner 29 Taylor Ave Ste 204, Crossville, TN 38555-4537 2020-08-08
1225648009 Angela R Davenport Nurse Practitioner 7110 Crossroads Blvd, Brentwood, TN 37027-2826 2020-08-05
1952919102 Renee Mathis Nurse Practitioner 2308 Collierville Arlington N, Eads, TN 38028-9302 2020-07-14
Find all providers with the same taxonomy

Competitor

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City KINGSPORT
Zip Code 37660

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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