Individual
NICHOLAS C STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD MD
Contact information
Practice address
42388 PELICAN PROFESSIONAL PARK, HAMMOND, LA 70403
(985) 542-6251
(985) 945-2386
Mailing address
PO BOX 1799, HAMMOND, LA 70404-1799
(985) 542-6251
(985) 945-2386
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
015218
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1198706
—
LA
01
—
2705080004
CIGNA HEALTHCARE OF LA
LA
01
—
4250496
AETNA US HEALTHCARE
LA
Enumeration date
07/12/2005
Last updated
08/23/2021
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