Provider Demographics
NPI:1902145451
Name:ALSTON, STEPHANIE (RN)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:ALSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 WATERS AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6267
Mailing Address - Country:US
Mailing Address - Phone:912-350-6543
Mailing Address - Fax:912-350-7690
Practice Address - Street 1:4750 WATERS AVE
Practice Address - Street 2:SUITE 452
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6200
Practice Address - Country:US
Practice Address - Phone:912-350-5800
Practice Address - Fax:912-350-5914
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN099870163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator