MEDICARE: WENDY JEAN STEVISON 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
1	363AM0700X	Medical Physician Assistant	PA9107058	FL
2	363A00000X	Physician Assistant	0010-09916	NC

General Provider Information

NPI Number	:	1902918188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY JEAN STEVISON PA-C

Provider Business Mailing Address
First Line	:	3451 PINE RIDGE RD BLDG 601
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-3922
Country	:	US
Telephone Number	:	239-449-3072
Fax Number	:	877-334-1886

Provider Business Practice Location Address
First Line	:	5601 ARRINGDON PARK DR STE 300
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-5677
Country	:	US
Telephone Number	:	919-660-5066
Fax Number	:	919-660-5044

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/09/2025

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