Provider Demographics
NPI:1720897796
Name:STEPHENS, SHANNON KRISTIN (NTP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:KRISTIN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 KITSON CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5016
Mailing Address - Country:US
Mailing Address - Phone:757-985-7111
Mailing Address - Fax:
Practice Address - Street 1:504 KITSON CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5016
Practice Address - Country:US
Practice Address - Phone:757-985-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach