Individual
JOHN-MARK STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2651 E DISCOVERY PARKWAY, BLOOMINGTON, IN 47408-9059
(812) 353-5252
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28228935A
IN
363L00000X
Nurse Practitioner
Primary
71014442A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28228935A
REGISTERED NURSE
IN
Enumeration date
09/12/2023
Last updated
10/23/2023
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