Individual
MS. KRISTIN BROOK STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OB GYN, NP
Contact information
Practice address
404 N CAYUGA STREET, ITHACA, NY 14850-4219
(607) 277-0969
(607) 277-3242
Mailing address
404 N CAYUGA STREET, ITHACA, NY 14850-4219
(607) 277-0969
(607) 277-3242
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22 438468
NY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
F360284-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02781744
—
NY
01
—
AA1307
MEDICARE GROUP
NY
Enumeration date
07/12/2006
Last updated
02/26/2015
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