Provider Demographics
NPI:1659250983
Name:AGYEMANG, STEPHANIE DENISE (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DENISE
Last Name:AGYEMANG
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:DISPUTANTA
Mailing Address - State:VA
Mailing Address - Zip Code:23842-0405
Mailing Address - Country:US
Mailing Address - Phone:804-522-6436
Mailing Address - Fax:804-522-6436
Practice Address - Street 1:PO BOX 405
Practice Address - Street 2:
Practice Address - City:DISPUTANTA
Practice Address - State:VA
Practice Address - Zip Code:23842-0405
Practice Address - Country:US
Practice Address - Phone:804-522-6436
Practice Address - Fax:804-522-6436
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANPCN-17565-15007246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy