| Doctor Name: | NINA STEVENS |
| NPI Number: | 1205248309 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | ARNP9378669 |
| Business Practice Address: | 1102 A1a N Suite 104 Ponte Vedra Beach, FL - 320824098 |
| Business Phone Number: | 9042736533 |
| Business Fax Number: | 9042736532 |
| Mailing Address: | 1102 A1a N, Suite 104 PONTE VEDRA BEACH |
| State: | FL |
| Postal Code: | 320824098 |
| Phone Number: | 9042736533 |
| Fax Number: | 9042736532 |
| NPI Enumeration Date: | 05/22/2014 |
| NPI Last Update Date: | 08/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | ARNP9378669 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |