Provider Demographics
NPI:1710776091
Name:STEPHENS, KAMARI JOYCE
Entity type:Individual
Prefix:
First Name:KAMARI
Middle Name:JOYCE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25644 GREENLAWN CT
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3263
Mailing Address - Country:US
Mailing Address - Phone:347-210-5914
Mailing Address - Fax:
Practice Address - Street 1:25644 GREENLAWN CT
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3263
Practice Address - Country:US
Practice Address - Phone:347-210-5914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist