Provider Demographics
NPI:1154127025
Name:STEVENSON, GABRIELLA LYN
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:LYN
Last Name:STEVENSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 S D RD
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:NE
Mailing Address - Zip Code:69357-3789
Mailing Address - Country:US
Mailing Address - Phone:360-346-3215
Mailing Address - Fax:
Practice Address - Street 1:1350 S D RD
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:NE
Practice Address - Zip Code:69357-3789
Practice Address - Country:US
Practice Address - Phone:360-346-3215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion