Individual
EVELYNN MALONE STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
330B HIGHWAY 90, GAUTIER, MS 39553-5744
(228) 497-0434
(228) 497-2391
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
(228) 497-1363
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
856563
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
07/21/2020
Last updated
07/21/2020
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