Individual
ELLA ELAINNE STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2550 W CLINTON AVE, FRESNO, CA 93705
(559) 264-7521
(805) 929-6440
Mailing address
2550 W CLINTON AVE, FRESNO, CA 93705
(559) 264-7521
(805) 929-6440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
470760
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
551983
MEDICARE
CA
05
—
FHC71031F
—
CA
01
—
W1508E
MEDICARE
CA
Enumeration date
07/14/2008
Last updated
08/19/2014
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