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NPI Code Detail

MEDICARE: LINDSAY MICHELLE STEVENS NP

MEDICARE: LINDSAY MICHELLE STEVENS NP
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
1363L00000XNurse Practitioner28173345AIN

General Provider Information

NPI Number : 1083277362
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY MICHELLE STEVENS NP
Provider Business Mailing Address
First Line : 801 YORK ST
Second Line :
City : MANITOWOC
State : WI
Zip : 54220-4630
Country : US
Telephone Number : 920-663-9008
Fax Number : 920-684-1439
Provider Business Practice Location Address
First Line : 4020 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1737
Country : US
Telephone Number : 260-425-2597
Fax Number : 260-420-2415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2019
Last Update Date : 09/21/2021

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