Stephens, Larry D

Stephens, Larry D is an individual health care provider with primary practice located at 1053 River Oaks Dr , Flowood MS 39232-9595. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Stephens, Larry D can be contacted via phone (601) 969-1430.

Contact Information

Primary practice address
1053 River Oaks Dr Flowood MS 39232-9595
Phone: (601) 969-1430
Fax: (601) 709-2117
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209021351 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R852085 Mississippi

Profile Details

NPI number 1932189628
LBN Legal business name Stephens, Larry D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated May 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932189628 NPPES
Mississippi MEDICAID 00122204
Mississippi Other 430002052

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