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General NPI Number Information
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NPI Number | 1639005762
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Entity Type | Individual
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Provider Name | SHENA LEE STEVENSON AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 335 BUSINESS ROUTE 63
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City | THAYER
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State | MO
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Zip | 65791-7748
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Country | US
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Telephone | 417-264-7256
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Fax | 417-264-3219
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Provider Business Mailing Address
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Address Line | 913 S STATE ROUTE 17
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City | MOUNTAIN VIEW
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State | MO
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Zip | 65548-8288
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Country | US
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Telephone | 417-264-7256
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Fax | 417-264-3219
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 2026019481
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License Number State | MO
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