Healthcare Provider Details

I. General information

NPI: 1578068383
Provider Name (Legal Business Name): VERONICA SUZANNE STEVENS APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 BAKER STREET
WELLS NV
89835
US

IV. Provider business mailing address

PO BOX 158
WELLS NV
89835-0158
US

V. Phone/Fax

Practice location:
  • Phone: 775-752-2111
  • Fax: 775-752-2112
Mailing address:
  • Phone: 775-752-2111
  • Fax: 775-752-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN002882
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN69333
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: