Individual
MRS. TARA LEE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2265803
MA
Other
Enumeration date
09/16/2006
Last updated
01/24/2012
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