Provider Demographics
NPI:1912950742
Name:STEPHENS, MARGARET (CRNP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 OLD WATERWORKS RD SW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3347
Mailing Address - Country:US
Mailing Address - Phone:256-997-5900
Mailing Address - Fax:256-997-5995
Practice Address - Street 1:1359 OLD WATER WORKS RD SW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3347
Practice Address - Country:US
Practice Address - Phone:256-997-5900
Practice Address - Fax:888-977-1691
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-022512363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL20369OtherBCBS
AL891003700Medicaid
AL20369OtherBCBS