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NPI Code Detail

MEDICARE: NANCY J STEVENSON PA-C

MEDICARE: NANCY J STEVENSON 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 Assistant214067-1206UT

General Provider Information

NPI Number : 1215997655
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY J STEVENSON PA-C
Provider Business Mailing Address
First Line : 4000 S 700 E
Second Line : STE 10
City : SLC
State : UT
Zip : 84107-2180
Country : US
Telephone Number : 801-268-4141
Fax Number : 801-261-8609
Provider Business Practice Location Address
First Line : 4000 S 700 E
Second Line : STE 10
City : SLC
State : UT
Zip : 84107-2180
Country : US
Telephone Number : 801-268-4141
Fax Number : 801-261-8609
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 07/08/2007

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Directions to “ NANCY J STEVENSON PA-C” Practice Location

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