Healthcare Provider Details

I. General information

NPI: 1497621353
Provider Name (Legal Business Name): HEATHER LYNN STEVENS AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CIVIC CENTER DR APT 25
AUGUSTA ME
04330-7973
US

IV. Provider business mailing address

314 HORSE POINT RD
BELGRADE ME
04917-3025
US

V. Phone/Fax

Practice location:
  • Phone: 207-955-6784
  • Fax: 207-349-4723
Mailing address:
  • Phone: 207-649-8071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP251914
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: