Individual
MRS. SHANNON MARIE STEVENS
Active
Individual
MRS. SHANNON MARIE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. S. P. T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2570
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23693
LOVELACE
NM
05
—
57831271
—
NM
01
—
73559
PRESBYTERIAN
NM
01
—
NM01Q136
BLUE CROSS BLUE SHIELD
NM
Enumeration date
10/12/2006
Last updated
10/26/2007
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