Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 041849 | NC |
NPI | 1114166618 |
---|---|
Provider Name | Mrs. Patricia Ann Stevens |
First Address | Hickory, NC 28602-9617 |
Second Address | Hickory, NC 28602-9617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2009 |
Last Update Date | 07/02/2009 |