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NPI Code Detail

MEDICARE: NATHAN LEE STEVENS RN

MEDICARE: NATHAN LEE STEVENS RN
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
1163W00000XRegistered NurseRN.360958OH

General Provider Information

NPI Number : 1902143241
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN LEE STEVENS RN
Provider Business Mailing Address
First Line : 11439 GALLIA PIKE RD
Second Line :
City : WHEELERSBURG
State : OH
Zip : 45694-7903
Country : US
Telephone Number : 740-981-6795
Fax Number :
Provider Business Practice Location Address
First Line : 2159 DOGWOOD RIDGE RD
Second Line :
City : WHEELERSBURG
State : OH
Zip : 45694-9044
Country : US
Telephone Number : 740-574-2558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2013
Last Update Date : 01/07/2013

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