Individual
DR. FAIREST STEVENSON-MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, MSN, RN
Contact information
Practice address
509 ASBURY LANE DR, PEARL, MS 39208-9314
(601) 502-6937
Mailing address
PO BOX 54554, PEARL, MS 39288-4554
(601) 502-6937
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
855363
MS
163WC3500X
Cardiac Rehabilitation Registered Nurse
Primary
855363
MS
163WG0000X
General Practice Registered Nurse
855363
MS
163WH0200X
Home Health Registered Nurse
855363
MS
Other
Enumeration date
12/27/2020
Last updated
12/27/2020
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