Individual
SHAYNA R STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 TRENT STREET, PRINCTON, WV 24740
(304) 425-7111
(304) 425-1138
Mailing address
355 BLUEFIELD AVE, BLUEFIELD, WV 24701-2883
(304) 425-7111
(304) 425-1138
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
1568796027
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55-6025355
—
WV
Enumeration date
12/10/2020
Last updated
03/11/2024
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