Individual
CLINTON STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2500 BELLE CHASSE HWY, TERRYTOWN, LA 70056-7127
(504) 391-5157
Mailing address
4620 S DERBIGNY ST, NEW ORLEANS, LA 70125-5014
(361) 649-6905
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP08879
LA
390200000X
Student in an Organized Health Care Education/Training Program
RN139455
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09523777
—
MS
05
—
2428535
—
LA
Enumeration date
04/07/2016
Last updated
11/04/2016
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