Individual
SHANE STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 MED TECH PKWY, JOHNSON CITY, TN 37604-2365
(423) 302-3480
(423) 833-0639
Mailing address
7032 ROBINETTE VALLEY RD, DUFFIELD, VA 24244-2979
(828) 551-5679
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
24695
TN
Other
Enumeration date
09/11/2018
Last updated
03/20/2024
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