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Individual

SUSAN ELISE STEVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
3100 MACCORKLE AVE SE STE B1, CHARLESTON, WV 25304-1222
(304) 345-0667
Mailing address
3415 MACCORKLE AVE SE, CHARLESTON, WV 25304-1334
(304) 388-1790

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
74114
WV

Other

Enumeration date
07/13/2012
Last updated
02/22/2017
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