MEDICARE: MRS. CATHERINE ELIZABETH STEVENS ARNP

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
1	363LF0000X	Family Nurse Practitioner	ARNP2759822	FL

General Provider Information

NPI Number	:	1669923041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHERINE ELIZABETH STEVENS ARNP

Provider Business Mailing Address
First Line	:	3109 TAMIAMI TRL
Second Line	:	STE 3
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8046
Country	:	US
Telephone Number	:	239-415-0502
Fax Number	:

Provider Business Practice Location Address
First Line	:	17281 PHLOX DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33967-2589
Country	:	US
Telephone Number	:	239-415-0502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	06/05/2019

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