Individual
KIMBERLLY JOY STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
145 NE BROADWAY ST, MYRTLE CREEK, OR 97457-9039
(541) 677-7200
(541) 229-3309
Mailing address
2589 NW EDENBOWER BLVD, ROSEBURG, OR 97471-6224
(541) 839-1345
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201703307NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500725333
—
OR
Enumeration date
05/12/2017
Last updated
04/26/2025
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