Individual
ANDREA NICOLE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1115 12TH AVE RD, NAMPA, ID 83686-5738
(208) 498-1080
(208) 498-1080
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
63151
ID
Other
Enumeration date
11/22/2019
Last updated
01/29/2020
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