Provider Demographics
NPI:1902465669
Name:BYARD, STEPHANIE LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEE
Last Name:BYARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LEE
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1553 ROSEBURY LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-7964
Mailing Address - Country:US
Mailing Address - Phone:931-237-7266
Mailing Address - Fax:
Practice Address - Street 1:236 UFFELMAN DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6566
Practice Address - Country:US
Practice Address - Phone:931-647-6305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical