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Individual

MRS. KRISTINE STEVENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGNP-C

Contact information

Practice address
11611 S FOOTHILLS BLVD STE F, YUMA, AZ 85367-5845
(928) 247-9277
Mailing address
11611 S FOOTHILLS BLVD STE F, YUMA, AZ 85367-5845
(928) 247-2275

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
255977
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
255977
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
159894
AZ
Enumeration date
05/16/2022
Last updated
01/16/2025
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