Individual
DR. CARRIE KIMBLE STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2014 DUDLEY AVE, PARKERSBURG, WV 26101-3405
(304) 422-1841
(304) 865-0592
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1532DT
KY
152W00000X
Optometrist
5264T2171
OH
152W00000X
Optometrist
Primary
960-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001212
—
WV
Enumeration date
08/11/2005
Last updated
04/15/2021
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