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Individual

JULIE A STEVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3520 E. LOUISE DR, MERIDIAN, ID 83642
(208) 955-0350
(208) 955-0352
Mailing address
3520 E. LOUISE DR, MERIDIAN, ID 83642
(208) 955-0350
(208) 955-0352

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
NP470A
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010148210
REGENCE BLUE SHIELD OF ID
ID
05
806990600
ID
01
NPJD1
BLUE CROSS OF IDAHO
ID
Enumeration date
01/25/2006
Last updated
01/15/2013
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