Provider Demographics
NPI:1396136586
Name:ANDERSON, STEPHANIE LEE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23015 NORTHOAK FOREST LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-3797
Mailing Address - Country:US
Mailing Address - Phone:832-498-2418
Mailing Address - Fax:
Practice Address - Street 1:635 W 19TH ST STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-4618
Practice Address - Country:US
Practice Address - Phone:832-498-2418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula