Individual
JESSICA STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10825 OLD HIGHWAY 64, BOLIVAR, TN 38008-3599
(731) 658-5291
Mailing address
10825 OLD HIGHWAY 64, BOLIVAR, TN 38008-3599
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN0000155227
TN
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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