Healthcare Provider Details

I. General information

NPI: 1700204377
Provider Name (Legal Business Name): MARY JO STEVEN MS, RN, ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 N COVE BLVD
TOLEDO OH
43606-3895
US

IV. Provider business mailing address

2142 N COVE BLVD
TOLEDO OH
43606-3895
US

V. Phone/Fax

Practice location:
  • Phone: 419-473-6633
  • Fax: 419-479-6956
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704260758
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.020723
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: