Individual
CALLIE STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 W 6TH AVE, GARY, IN 46402
(219) 886-4264
Mailing address
705 RED OAK LN, #3, UNIVERSITY PARK, IL 60484-2922
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27067077A
IN
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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