Stephanie Jean Boughner, PT, DPT
Individual provider Active NPI Physical Therapist · Ruston, LA
NPI 1972125045 · NPPES record last updated Feb 27, 2023
Key facts
- NPI
- 1972125045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10432R (LA)
- Practice address
- 1603 Goodwin Rd
Ruston, LA 71270-2907 - Phone
- (318) 225-7550
- NPI assigned
- May 12, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10432R | LA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10432R | LA | Yes |
Addresses
Primary practice location
1603 Goodwin Rd
Ruston, LA 71270-2907
Mailing address
136 Cherrybark Way
Choudrant, LA 71227-5030
Phone (479) 629-5360
Other names
- Stephanie Jean Sharum
Other providers in Ruston, LA
- Bonnie Lejeune Buller, LLC
- Heather Taylor Boone
- Brandi Elizabeth Bordelon
- Angelica Boston
- Adrianne Marie Bosworth
- Rebecca Barr Bourgeois
- Kate Bower
- Tiffany Taylor Bowman
- Fateemah Boykin
- Jessica Boyles
All providers in Ruston, LA · Physical Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.