Basic Information
| Provider Information | |||||||||
| NPI: | 1740256619 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWEET | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | DIANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4860 Y ST | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958172307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167346900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1005 DR DB TODD JR BLVD | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372083501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153275944 | ||||||||
| FaxNumber: | 6153275555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2006 | ||||||||
| LastUpdateDate: | 10/18/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 27001 | TN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | G89068 | CA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 3093581 | 05 | TN | MEDICAID |