MS. KERRY ROSE STEPHENSON


Address: 575 Main St Fl 2, Attn: Credentialing Dpt, Middletown, CT 06457-2845
Phone: 8603476971

MS. KERRY ROSE STEPHENSON (NPI# 1497944425) 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) 1497944425
Entity Type Individual
Full Name MS. KERRY ROSE STEPHENSON
Credential APRN
Practice Address 575 Main St Fl 2
Attn: Credentialing Dpt
Middletown
CT 06457-2845
Mailing Address 1 Shaws Cv
New London
CT 06320-4902
Practice Telephone 8603476971
Mailing Telephone 8604478304
Mailing Fax Number 8604438720
Enumeration Date 2007-10-16
Last Update Date 2012-02-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
003654 CT Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT 004236338 05

Office Location

Street Address 575 MAIN ST FL 2
ATTN: CREDENTIALING DPT
City MIDDLETOWN
State CT
Zip Code 06457-2845

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801412960 Amanda Poling-tierney Psychologist 575 Main St Fl 2, Middletown, CT 06457-2845 2020-06-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699391961 Meghan Harrington Behavior Technician 101 Centerpoint Drive #243, Middletown, CT 06457 2020-06-22
1427619626 Collaborative Aba Services, LLC Behavioral Analyst 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 2019-06-27
1376100339 Kimberly Tynik Pharmacist 451 Fowler Ave, Middletown, CT 06457 2019-05-24
1184101263 Tabrez Adil Dentist 675 Main St., Middletown, CT 06457 2018-07-23
1326535337 Rehan Khan Non-emergency Medical Transport (VAN) 765 Country Club Rd, Middletown, CT 06457 2018-04-16
1366950206 State of Connecticut Psychiatric Hospital 70 O'brien Drive, Middletown, CT 06457 2018-01-12
1902324536 Cynthia Tine Physical Therapy Assistant 628 Congdon Street, Middletown, CT 06457 2017-09-04
1619494390 Nathan Douglas Roy Specialist/Technologist 431 Briarwood Lane, Middletown, CT 06457 2017-08-24
1598286502 Rachel Hoffman Whelen Registered Nurse 420 Saybrook Road, Suite A, Middletown, CT 06457 2017-06-29
1003358326 Rebecca Rotondo Social Worker 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 2016-11-17
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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144820077 Karen Wood Nurse Practitioner 1272 W Main Rd Bldg 3, Middletown, RI 02842-6335 2020-10-29
1194140400 Lorna A Divino Nurse Practitioner 200 Cleaver Farms Rd Ste 201, Middletown, DE 19709 2014-02-24
1891125654 Talena Ullery Nurse Practitioner 200 Hollytree Dr, Middletown, OH 45044-3340 2013-11-14
1821345018 Winifred S. O. Mellinger Nurse Practitioner 122 Silver Lake Road, Middletown School Based Health Center, Middletown, DE 19709 2012-08-07
1942812623 Priyanka Tadepalli Nurse Practitioner 707 E Main St, Middletown, NY 10940-2650 2020-08-23
1750856274 Caroline Elizabeth Stockert Nurse Practitioner 300 Crystal Run Rd, Middletown, NY 10941-4069 2018-10-11
1669955910 Lauren Michelle Grant Nurse Practitioner 333 Conover Dr Ste B, Middletown, OH 45005-1900 2018-09-12
1437435419 Sandra Dawn Fomenko Nurse Practitioner 635 Main St, Middletown, CT 06457-2718 2011-10-22
1104112531 Sandra Louise Bailey Nurse Practitioner 331 N Breiel Blvd, Middletown, OH 45042-3868 2011-06-23
1528249331 Jennifer Darcy Hill Nurse Practitioner 635 Main St, Middletown, CT 06457-2718 2007-11-20
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Competitor

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City MIDDLETOWN
Zip Code 06457

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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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