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NPI Code Detail

MEDICARE: MS. DIANE E STEVENS P.T.

MEDICARE: MS. DIANE E STEVENS P.T.
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
12251P0200XPediatric Physical Therapist05001122AIN

General Provider Information

NPI Number : 1912045576
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANE E STEVENS P.T.
Provider Business Mailing Address
First Line : 1595 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-2389
Country : US
Telephone Number : 219-764-4888
Fax Number : 219-898-4258
Provider Business Practice Location Address
First Line : 1595 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-2389
Country : US
Telephone Number : 219-764-4888
Fax Number : 219-898-4258
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 08/28/2024

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Directions to “ MS. DIANE E STEVENS P.T.” Practice Location

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