MEDICARE: MRS. LAWANDA STEVENS

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	225400000X	Rehabilitation Practitioner	NV20141085404	NV

General Provider Information

NPI Number	:	1811311384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAWANDA STEVENS

Provider Business Mailing Address
First Line	:	1601 HEATHER OAKS WAY
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-5011
Country	:	US
Telephone Number	:	702-217-1292
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 HEATHER OAKS WAY
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-5011
Country	:	US
Telephone Number	:	702-217-1292
Fax Number	:

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

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	02/22/2014

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Directions to “ MRS. LAWANDA STEVENS ” Practice Location

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