Individual
MR. LARRY MICHAEL STEVENS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604-6089
(423) 431-1810
(423) 431-1811
Mailing address
408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604-6089
(423) 431-1810
(423) 431-1811
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
13439
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053567826
—
NC
05
—
1053567826
—
VA
05
—
1507311
—
TN
05
—
7100117150
—
KY
Enumeration date
08/13/2008
Last updated
02/23/2017
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