Individual
KENYATTA ANTOINETTE STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN
Contact information
Practice address
34369 RAMBLE HILLS DR, FARMINGTON HILLS, MI 48331-4227
(248) 396-5419
Mailing address
34369 RAMBLE HILLS DR, FARMINGTON HILLS, MI 48331-4227
(248) 396-5419
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
4704190836
MI
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704190836
MI
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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