Healthcare Provider Details

I. General information

NPI: 1902018518
Provider Name (Legal Business Name): CHRISTY DAWN STEVENS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S PRATT AVE
CARSON CITY NV
89701-4730
US

IV. Provider business mailing address

205 S PRATT AVE
CARSON CITY NV
89701-4730
US

V. Phone/Fax

Practice location:
  • Phone: 775-882-3945
  • Fax: 775-882-6126
Mailing address:
  • Phone: 775-882-3945
  • Fax: 758-826-1267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN00522
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN00522
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN32798
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: