Individual
TARA STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 W MUD RIVER RD, MILTON, WV 25541-9380
(304) 972-3881
Mailing address
1717 W MUD RIVER RD, MILTON, WV 25541-9380
(304) 972-3881
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
76774
WV
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
76774
WV
163WC1500X
Community Health Registered Nurse
76774
WV
Other
Enumeration date
02/17/2022
Last updated
03/10/2022
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