Healthcare Provider Details

I. General information

NPI: 1750242103
Provider Name (Legal Business Name): SIENNA STEVENSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2469 W HILL RD
FLINT MI
48507-3883
US

IV. Provider business mailing address

8993 HAYMARKET ST
WHITE LAKE MI
48386-3395
US

V. Phone/Fax

Practice location:
  • Phone: 810-339-8261
  • Fax:
Mailing address:
  • Phone: 989-305-5812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704363013
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: