Individual
KEISHA STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 BRIDGEPORT AVE STE 204, SHELTON, CT 06484-4700
(203) 929-1954
Mailing address
525 BRIDGEPORT AVE STE 204, SHELTON, CT 06484-4700
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12459
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137006
REGISTERED NURSE
CT
Enumeration date
05/06/2021
Last updated
07/07/2025
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