Provider Demographics
NPI:1487380473
Name:BLAND, STEPHANIE DANIELLE JONES (FNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DANIELLE JONES
Last Name:BLAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4191 LANSDOWNE DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-3360
Mailing Address - Country:US
Mailing Address - Phone:901-500-8483
Mailing Address - Fax:
Practice Address - Street 1:9155 POPLAR AVE STE 27
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-7910
Practice Address - Country:US
Practice Address - Phone:901-545-2282
Practice Address - Fax:888-714-0072
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily