Provider Demographics
NPI:1124638184
Name:STEPHENS, SYMONE (WHNP-BC)
Entity type:Individual
Prefix:
First Name:SYMONE
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:1 E 31ST ST # N200
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3902
Practice Address - Country:US
Practice Address - Phone:410-516-3311
Practice Address - Fax:410-516-4784
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC006141363LW0102X
MDR266153363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health