Individual
LISA STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
10 SUNNYBROOK RD, RALEIGH, NC 27610-1808
(919) 212-7000
Mailing address
10 SUNNYBROOK RD, RALEIGH, NC 27610-1808
(919) 212-7000
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
0024166990
VA
367A00000X
Advanced Practice Midwife
Primary
164
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010293821
—
VA
01
—
018694O45
MEDICARE PTAN
VA
01
—
10012208M
OPTIMA
VA
01
—
210104
ANTHEM
VA
01
—
C02245
MEDICARE PTAN
VA
01
—
CN3911
RAILROAD MEDICARE PTAN
VA
Enumeration date
06/29/2006
Last updated
12/08/2022
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