MEDICARE: MS. KATHLEEN ANN STEVER N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	4704167377	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851694327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN ANN STEVER N.P.

Provider Business Mailing Address
First Line	:	530 W OAKRIDGE ST
Second Line	:
City	:	FERNDALE
State	:	MI
Zip	:	48220-2725
Country	:	US
Telephone Number	:	248-345-4106
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 STEPHENSON HWY
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-1115
Country	:	US
Telephone Number	:	248-743-9400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2010
Last Update Date	:	12/06/2010

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