MEDICARE: DR. EVA STEPHENS NURSE PRACTITIONER

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	256765	TX
2	363LF0000X	Family Nurse Practitioner	R103027	MD
3	363LF0000X	Family Nurse Practitioner	RN53673	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962439679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVA STEPHENS NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	906 ASPEN ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-2512
Country	:	US
Telephone Number	:	202-806-5601
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251B SARATOGA AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1025
Country	:	US
Telephone Number	:	202-832-8818
Fax Number	:	202-832-8575

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	05/13/2021

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