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General NPI Number Information
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NPI Number | 1871589069
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Entity Type | Individual
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Provider Name | LAUREL ANNE STEVENS CFNP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1010 SPRUCE ST ESPANOLA HOSPITAL
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City | ESPANOLA
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State | NM
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Zip | 87532
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Country | US
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Telephone | 505-753-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 23 VISTA DEL OCASO RD
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City | RANCHOS DE TAOS
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State | NM
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Zip | 87557
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Country | US
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Telephone | 505-737-9608
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R42934
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License Number State | NM
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