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General NPI Number Information
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NPI Number | 1114220613
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Entity Type | Individual
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Provider Name | BRUCE JAMIE STEVENS APRN
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Gender | Male
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 202D MCGILL AVE NW
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City | CONCORD
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State | NC
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Zip | 28025-4615
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Country | US
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Telephone | 704-792-2315
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Fax | 844-269-8197
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Provider Business Mailing Address
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Address Line | 6209 KNIGHTSGATE CT
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City | CHARLOTTE
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State | NC
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Zip | 28269-0603
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Country | US
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Telephone | 203-693-1510
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Fax | 938-253-3590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4567
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License Number State | CT
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