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Individual

MR. DEWAYNE SCOTT STEFFEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Mailing address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN7390
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103G706781
GROUP MEDICARE PTAN
TN
01
1831467067
GROUP NPI
TN
01
3386406
MEDICARE PTAN
TN
Enumeration date
08/16/2005
Last updated
11/05/2013
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