Individual
SAMANTHA JO STEVENS
Active
Individual
SAMANTHA JO STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28185263A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102343973
ANTHEM PTAN
IN
01
—
163460043
MEDICARE
IN
05
—
201339310
—
IN
01
—
940070017
MEDICARE
IN
Enumeration date
01/30/2015
Last updated
05/29/2024
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