Healthcare Provider Details

I. General information

NPI: 1114813417
Provider Name (Legal Business Name): MICHELE MARIA STEVANOVICH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4095 N CARSON ST
CARSON CITY NV
89706-1936
US

IV. Provider business mailing address

1160 DAMONTE RANCH PKWY UNIT 1168
RENO NV
89521-4547
US

V. Phone/Fax

Practice location:
  • Phone: 775-224-5172
  • Fax: 775-885-2785
Mailing address:
  • Phone: 775-224-5172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number890948
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number890948
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: