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General NPI Number Information
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NPI Number | 1134542343
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Entity Type | Individual
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Provider Name | MARIE STEVENS PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/23/2014
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Last Update Date | 11/08/2025
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Provider Practice Location Address
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Address Line | 2870 E GRAND BLVD STE 600 PMB 1042
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City | DETROIT
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State | MI
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Zip | 48202
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Country | US
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Telephone | 231-239-6101
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Fax | 231-251-8267
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Provider Business Mailing Address
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Address Line | 1571 SUNDOWN DR
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City | HENDERSON
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State | NV
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Zip | 89002-8843
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Country | US
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Telephone | 231-239-6101
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Fax | 231-251-8267
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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 | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 5601012176
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601012176
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License Number State | MI
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