Individual
LOPASTEEDA DEROSA STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
915 N CHANCERY ST, STE 120, MCMINNVILLE, TN 37110-1575
(931) 473-6865
(931) 473-5269
Mailing address
PO BOX 308, MC MINNVILLE, TN 37111-0308
(931) 473-6865
(931) 473-5870
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
030.0134031TELE
VT
152W00000X
Optometrist
36116
CA
152W00000X
Optometrist
4108-35
WI
152W00000X
Optometrist
905-IOD
WV
152W00000X
Optometrist
Primary
OD0000001363
TN
152W00000X
Optometrist
OPT-2025-0020
NM
152W00000X
Optometrist
OPT.0004135
CO
152W00000X
Optometrist
OPT.007417
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3598018
—
TN
Enumeration date
06/13/2005
Last updated
12/16/2025
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