| Doctor Name: | MISS MATILDA ELLIOTT STEPHENS |
| NPI Number: | 1003999459 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | APO4970 |
| Business Practice Address: | 3400 Medical Park Dr Monroe, LA - 712032388 |
| Business Phone Number: | 3183876803 |
| Business Fax Number: | 3183876874 |
| Mailing Address: | 130 Desiard St, Suite 35 MONROE |
| State: | LA |
| Postal Code: | 712017319 |
| Phone Number: | 3188077875 |
| Fax Number: | 3188126603 |
| NPI Enumeration Date: | 10/21/2006 |
| NPI Last Update Date: | 01/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APO4970 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |