Individual
KELLI LYNN STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1289 ROBERT C BYRD DRIVE, BECKLEY, WV 25802
(304) 253-8979
Mailing address
PO BOX 687, BECKLEY, WV 25802-0687
(304) 253-8979
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3747P1801X
—
WV
Enumeration date
12/28/2020
Last updated
10/18/2021
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