Provider Demographics
NPI:1194334581
Name:STEPHENSON, SYLVIA (APNP)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6868 N GREEN BAY AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2864
Mailing Address - Country:US
Mailing Address - Phone:414-364-1095
Mailing Address - Fax:
Practice Address - Street 1:10701 W RESEARCH DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3452
Practice Address - Country:US
Practice Address - Phone:615-224-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10107-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily