Provider Demographics
NPI:1063696177
Name:STEVENS, ARLENE (CRNP-F)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:CRNP-F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:MD
Mailing Address - Zip Code:21655-0331
Mailing Address - Country:US
Mailing Address - Phone:410-673-1690
Mailing Address - Fax:410-673-1692
Practice Address - Street 1:136 LEDNUM AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:PRESTON
Practice Address - State:MD
Practice Address - Zip Code:21655
Practice Address - Country:US
Practice Address - Phone:410-673-1690
Practice Address - Fax:410-673-1692
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR111187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily