Individual
STEPHANIE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
70 KENYON AVE, SUITE 326, WAKEFIELD, RI 02879-4239
(401) 789-8543
(401) 782-8766
Mailing address
70 KENYON AVE, SUITE 326, WAKEFIELD, RI 02879-4239
(401) 789-8543
(401) 782-8766
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
RI00010
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000094
RHODE ISLAND BLUE CROSS/ BLUE SHIELD
RI
01
—
000196
RHODE ISLAND BLUE CHIP
RI
05
—
ID9000094
—
RI
Enumeration date
08/31/2006
Last updated
05/22/2008
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