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General NPI Number Information
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NPI Number | 1700290244
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Entity Type | Individual
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Provider Name | EILEEN B STEVENS
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Gender | Female
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 06/27/2014
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Provider Practice Location Address
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Address Line | 2655 NORTHWINDS PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30009-2280
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Country | US
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Telephone | 678-690-8334
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Fax |
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Provider Business Mailing Address
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Address Line | 700 GOLD CUP DR
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City | WARRENTON
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State | VA
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Zip | 20186-2373
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Country | US
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Telephone | 540-216-3477
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Fax |
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 0001120258
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License Number State | VA
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