Individual
CORINNE T. STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3202 MCINTOSH CIR STE 301, JOPLIN, MO 64804
(417) 347-8430
(417) 347-8434
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-7272
(417) 347-7915
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2000158193
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200077800A
—
OK
05
—
200371340A
—
KS
01
—
206425
ANTHEM
MO
05
—
420246209
—
MO
01
—
P00296873
RR MEDICARE
MO
Enumeration date
06/23/2006
Last updated
04/29/2019
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