Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN02473 | RI |
NPI | 1023522703 |
---|---|
Provider Name | Rebecca Stevenson |
First Address | Cranston, RI 02920-6043 |
Second Address | Cranston, RI 02920-6043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2017 |
Last Update Date | 25/11/2020 |