Individual
DR. LISA DAWN STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1950 GLENN MITCHELL DR STE 310, VIRGINIA BEACH, VA 23456-0019
(757) 507-0255
Mailing address
1950 GLENN MITCHELL DR STE 310, VIRGINIA BEACH, VA 23456-0019
(757) 507-0255
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101226853
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006702171
VA PREMIER
—
05
—
006702171
—
VI
01
—
22927925
VIRGINIA HEALTH NETWORK
—
01
—
229529252
UNITED HEALTH CARE
—
01
—
282142
MDIPA/MAMSI
—
01
—
29851
OPTIMA
—
01
—
452258
ANTHEM
—
01
—
541778786001
TRICARE
—
05
—
89063N4
—
NC
Enumeration date
06/13/2006
Last updated
05/30/2024
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