Individual
JACQUELYN G STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
113 GAINSBOROUGH SQ STE 201, CHESAPEAKE, VA 23320-1714
(757) 842-4620
(757) 842-4621
Mailing address
667 KINGSBOROUGH SQ STE 101, CHESAPEAKE, VA 23320-4999
(757) 842-4481
(757) 312-3135
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001137127
VA
176B00000X
Midwife
Primary
0024164424
VA
363L00000X
Nurse Practitioner
0024164424
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053556209
—
VA
Enumeration date
12/02/2008
Last updated
06/24/2024
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