Healthcare Provider Details

I. General information

NPI: 1932304839
Provider Name (Legal Business Name): HEATHER L STEVENS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6261 N LA CHOLLA BLVD STE 277
TUCSON AZ
85741-3564
US

IV. Provider business mailing address

2424 W. WYATT DR. SUITE 260
TUCSON AZ
85712-6118
US

V. Phone/Fax

Practice location:
  • Phone: 520-877-3800
  • Fax: 520-877-3801
Mailing address:
  • Phone: 520-545-0608
  • Fax: 520-795-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME106982
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number47645
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: