Individual
JANIS FARQUHAR STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
2920 MCINTYRE DR, SUITE 150, BLOOMINGTON, IN 47403-4221
(812) 333-7246
(812) 333-4471
Mailing address
PO BOX 5635, ATTN: MARIA MITCHELL, BLOOMINGTON, IN 47407-5635
(812) 337-5003
(812) 337-5010
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
71001894A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000368824
CSC ANTHEM
IN
01
—
000000368846
PMC ANTHEM
IN
Enumeration date
09/14/2005
Last updated
07/08/2007
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