Individual provider Active NPI

Yvette E Stephenson, RNC

  • Women's Health Nurse Practitioner
  • Jbsa Lackland, TX
National Provider Identifier
1235192097
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
578861 Issued in TX
Practice address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236
Phone
(210) 520-3078
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 578861 TX Primary

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 520-3078

Other identifiers 1

IdentifierTypeStateIssuer
578861OtherTXREGISTERD NURSE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1235192097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-520-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-520-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "YVETTE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "RNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "578861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERD NURSE LICENSE",
            "identifier": "578861",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.