Individual
QUIANA LYNELL STEPHENS-MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN CPNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704245159
MI
363LP0200X
Pediatric Nurse Practitioner
Primary
4704245159
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164553099
—
MI
01
—
5008721450
BC IND PIN
MI
Enumeration date
09/04/2012
Last updated
12/10/2025
Update your record
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