Provider Demographics
NPI:1053690826
Name:STEPHENS, CHRISTI BROCK (RNFA,CNOR)
Entity type:Individual
Prefix:MS
First Name:CHRISTI
Middle Name:BROCK
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:RNFA,CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 COLLINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-4540
Mailing Address - Country:US
Mailing Address - Phone:817-800-8386
Mailing Address - Fax:817-295-4992
Practice Address - Street 1:3809 COLLINWOOD AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-4540
Practice Address - Country:US
Practice Address - Phone:817-800-8386
Practice Address - Fax:817-295-4992
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX573763163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical