Individual
MS. TRACY STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
280 SEWARD STREET, ROCHESTER, NY 14608
(585) 201-9008
(585) 235-4123
Mailing address
280 SEWARD STREET, ROCHESTER, NY 14608
(585) 201-9008
(585) 235-4123
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
494408
NY
374T00000X
Religious Nonmedical Nursing Personnel
Primary
494408-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02141808
—
NY
Enumeration date
02/11/2008
Last updated
06/20/2011
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