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NPI Code Detail

MEDICARE: MRS. MARGO V. STEVENS APRN

MEDICARE: MRS. MARGO V. STEVENS APRN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner209808-4405UT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4500030249OTHERUTRCAR- RAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1638896OTHERUTDESERET MUTUAL
2942938348005OTHERUTCHAMPUS
3107002816101OTHERUTINTERMOUNTAIN HEALTH CARE
5942938348MGOOTHERUTEDUCATORS MUTUAL

General Provider Information

NPI Number : 1275518185
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARGO V. STEVENS APRN
Provider Business Mailing Address
First Line : 430 G ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84103-3109
Country : US
Telephone Number : 801-355-7582
Fax Number :
Provider Business Practice Location Address
First Line : 1020 S MAIN ST
Second Line : SUITE 100
City : SALT LAKE CITY
State : UT
Zip : 84101-3176
Country : US
Telephone Number : 801-539-7000
Fax Number : 801-539-7050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 08/09/2011

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