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Individual

FLETCHER M STEVENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
69677
WV
367500000X
Certified Registered Nurse Anesthetist
APN10713
TN
367500000X
Certified Registered Nurse Anesthetist
RN143453
TN
367500000X
Certified Registered Nurse Anesthetist
RN170816
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001706470
MSBCBS GROUP
WV
01
001945814
MSBCBS
WV
05
0207026000
WV
01
1071314
BRICKSTREET
WV
05
2460484
OH
01
27005299700
BRICKSTREET GROUP
WV
01
270052997003
TRICARE GROUP
WV
05
2802800
OH
05
3630211
TN
05
3810008135
WV
01
4078445
BCBS
TN
Enumeration date
02/28/2006
Last updated
06/28/2013
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