Individual
MEKEIA H STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6320A W UNION HILLS DR, STE 265, GLENDALE, AZ 85308-1098
(623) 374-2424
(623) 374-2619
Mailing address
4123 ASHMORE DR, GREENSBORO, NC 27405-6301
(336) 708-9266
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2023
VA
225100000X
Physical Therapist
9447
AZ
225100000X
Physical Therapist
9619
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079RX
BLUE CROSS BLUE SHIELD
NC
05
—
7211729
—
NC
01
—
E2225
MEDCOST
NC
01
—
P00319082
MEDICARE RAILROAD
NC
01
—
Z155550
MEDICARE PTAN
AZ
Enumeration date
11/10/2005
Last updated
03/07/2023
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