Healthcare Provider Details

I. General information

NPI: 1508661331
Provider Name (Legal Business Name): BRIANNAH STEVENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 N FRANKLIN ST
DELAWARE OH
43015-1248
US

IV. Provider business mailing address

430 N FRANKLIN ST
DELAWARE OH
43015-1248
US

V. Phone/Fax

Practice location:
  • Phone: 740-972-6903
  • Fax:
Mailing address:
  • Phone: 740-972-6903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: