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General NPI Number Information
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NPI Number | 1891206645
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Entity Type | Individual
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Provider Name | VICKIE LYNNE STEVENS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 5296 REDBUD HWY
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City | HONAKER
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State | VA
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Zip | 24260-7379
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Country | US
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Telephone | 276-991-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 TERRACE DR
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City | MARION
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State | VA
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Zip | 24354-4138
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Country | US
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Telephone | 276-783-1827
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Fax | 276-783-2879
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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 | 002417557
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License Number State | VA
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