Provider Demographics
NPI:1447289129
Name:CAVE, STEPHANIE F (MS, MD, FAAFP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:F
Last Name:CAVE
Suffix:
Gender:F
Credentials:MS, MD, FAAFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10562 S GLENSTONE PL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2875
Mailing Address - Country:US
Mailing Address - Phone:225-767-7433
Mailing Address - Fax:225-767-4641
Practice Address - Street 1:10562 S GLENSTONE PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2875
Practice Address - Country:US
Practice Address - Phone:225-767-7433
Practice Address - Fax:225-767-4641
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB62606Medicare UPIN