Individual
MRS. KIMBERLY CARLY NICOLE STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
908 SCARBRO RD, SCARBRO, WV 25917-8837
(304) 469-2905
Mailing address
908 SCARBRO RD, SCARBRO, WV 25917-8837
(304) 469-2905
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
467275
OH
163W00000X
Registered Nurse
97400
WV
363LF0000X
Family Nurse Practitioner
Primary
0024180856
VA
363LF0000X
Family Nurse Practitioner
108428
WV
Other
Enumeration date
04/11/2018
Last updated
03/10/2021
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