Individual
ELLEN STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 776-6577
Mailing address
304 CLARK ST, WAYLAND, NY 14572-1008
(585) 728-2237
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400821-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0F400821
—
NY
Enumeration date
09/20/2006
Last updated
01/20/2010
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