Provider Demographics
NPI:1568453330
Name:STEVENS, JANET (NP)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1009 WINDCROSS CT
Mailing Address - Street 2:STE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2678
Mailing Address - Country:US
Mailing Address - Phone:615-224-5438
Mailing Address - Fax:855-247-8787
Practice Address - Street 1:1 PENN PLZ
Practice Address - Street 2:STE 725
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10119-0002
Practice Address - Country:US
Practice Address - Phone:615-224-5438
Practice Address - Fax:855-247-8787
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY311280363L00000X
NY300944363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01969328Medicaid
NY01969328Medicaid
P00966Medicare UPIN