Individual
KELLY NICOLE STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP
Contact information
Practice address
17094 FERRY DOCK RD, KING GEORGE, VA 22485-6101
(540) 413-1509
(540) 675-4326
Mailing address
17094 FERRY DOCK RD, KING GEORGE, VA 22485-6101
(540) 413-1509
(540) 675-4326
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024178294
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024178294
VA
Other
Enumeration date
10/11/2019
Last updated
12/30/2025
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