Individual
LAURA A STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2660 REIDVILLE RD UNIT 1, SPARTANBURG, SC 29301-3512
(864) 560-9696
(864) 560-9636
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
79224
SC
363L00000X
Nurse Practitioner
Primary
19541
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3266
—
SC
01
—
SC61016067
MEDICARE PIN
SC
Enumeration date
05/06/2015
Last updated
12/29/2020
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