Provider Demographics
NPI:1124762240
Name:CYPRESS, STEPHANIE LOVE (PMHNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LOVE
Last Name:CYPRESS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 NW HILL ST STE 4
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2960
Mailing Address - Country:US
Mailing Address - Phone:541-848-0778
Mailing Address - Fax:844-927-4453
Practice Address - Street 1:911 NE 4TH ST STE 1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4647
Practice Address - Country:US
Practice Address - Phone:541-848-0778
Practice Address - Fax:844-927-4453
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202204365NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health