Individual
DR. DANIELLE STREET STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
105 W STONE DR STE 2A, KINGSPORT, TN 37660-3365
(423) 857-2066
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
DO02949
TN
208000000X
Pediatrics Physician
R3339
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2013
Last updated
02/16/2021
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