Individual
DR. ERICA LYNN STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
411 E CHESTNUT ST, LOUISVILLE, KY 40202-1713
(502) 588-4940
(502) 588-7712
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5063
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
53456
KY
2080P0214X
Pediatric Pulmonology Physician
01085389A
IN
2080P0214X
Pediatric Pulmonology Physician
Primary
53456
KY
390200000X
Student in an Organized Health Care Education/Training Program
MD461129
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT212692
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01085389A
INDIANA MEDICAL LICENSE
IN
01
—
01085389B
INDIANA CSR LICENSE
IN
01
—
53456
KENTUCKY MEDICAL LICENSE
KY
01
—
MD461129
FULL UNRESTRICTED MEDICAL LICENSE
PA
01
—
MT212692
MEDICAL TRAINING LICENSE
PA
Enumeration date
03/31/2014
Last updated
11/22/2022
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