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NPI Code Detail

MEDICARE: DEVAN STEVENS MS OTR, PA-C

MEDICARE: DEVAN STEVENS MS OTR, PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2225XP0019XPhysical Rehabilitation Occupational Therapist225XP0019XNV

General Provider Information

NPI Number : 1033546536
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVAN STEVENS MS OTR, PA-C
Provider Business Mailing Address
First Line : 1620 STIRRUP DR
Second Line :
City : HENDERSON
State : NV
Zip : 89002-8824
Country : US
Telephone Number : 702-578-6271
Fax Number :
Provider Business Practice Location Address
First Line : 901 RANCHO LN STE 135
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-3826
Country : US
Telephone Number : 702-383-1958
Fax Number : 702-383-8235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2013
Last Update Date : 03/17/2025

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