Doctor Name: | JENNIFER ROSE STEVENS |
NPI Number: | 1396001517 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 201404734NP-PP |
Business Practice Address: | 347 Fairview Street Silverton, OR - 97381 |
Business Phone Number: | 5038735667 |
Business Fax Number: | 5038735687 |
Mailing Address: | 347 Fairview St, SILVERTON |
State: | OR |
Postal Code: | 973811916 |
Phone Number: | 5038735667 |
Fax Number: | 5038735687 |
NPI Enumeration Date: | 04/03/2012 |
NPI Last Update Date: | 07/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 201404734NP-PP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |