Stephens, Shasta M

Stephens, Shasta M is an individual health care provider with primary practice located at 1111 Crater Lake Ave , Medford OR 97504-6241. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Stephens, Shasta M can be contacted via phone (541) 732-5545.

Contact Information

Primary practice address
1111 Crater Lake Ave Medford OR 97504-6241
Phone: (541) 732-5545
Fax: (541) 732-5548
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 202010137NP-PP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 307579 New York
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 95006534 California

Profile Details

NPI number 1417312315
LBN Legal business name Stephens, Shasta M
Credentials AGACNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2015
Last updated Mar 15th, 2023 - about last year

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 1417312315 NPPES
Oregon MEDICAID 500786244

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