Provider Demographics
NPI:1154119527
Name:STEPHENS, ROMALIN (LPN)
Entity type:Individual
Prefix:
First Name:ROMALIN
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-2758
Mailing Address - Country:US
Mailing Address - Phone:475-449-6268
Mailing Address - Fax:
Practice Address - Street 1:178 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2758
Practice Address - Country:US
Practice Address - Phone:475-449-6268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT35687164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse