Healthcare Provider Details

I. General information

NPI: 1487610168
Provider Name (Legal Business Name): SUSAN P STEVENS APRN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 E MAIN ST
WESTBOROUGH MA
01581-1768
US

IV. Provider business mailing address

23 RUGGLES ST
WESTBOROUGH MA
01581-2032
US

V. Phone/Fax

Practice location:
  • Phone: 508-870-0647
  • Fax: 508-316-5846
Mailing address:
  • Phone: 617-201-4846
  • Fax: 508-316-5846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number236049
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: