Individual
DOUGLAS JEROME STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, ACNP
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-116653
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051121332
BCBS
AL
01
—
051121333
BCBS
AL
01
—
051121335
BCBS
AL
05
—
05224859
—
MS
05
—
134772
—
AL
05
—
134774
—
AL
05
—
134775
—
AL
01
—
Z30034
VIVA
AL
Enumeration date
09/01/2011
Last updated
06/29/2023
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