Provider Demographics
NPI:1699715896
Name:STEVENS, DEBRA L (APRN, BC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:F
Credentials:APRN, BC
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Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:CARL J. SHAPIRO CLINICAL CENTER 6TH FLOOR NORTH SUITE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-9600
Mailing Address - Fax:617-667-9619
Practice Address - Street 1:330 BROOKLINE AVENUE
Practice Address - Street 2:CARL J. SHAPIRO CLINICAL CENTER 6TH FLOOR NORTH SUITE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-9600
Practice Address - Fax:617-667-9619
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA242829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3681OtherBLUC CROSS BLUE SHIELD
MAST-NP3681Medicare ID - Type Unspecified
MANP3681OtherBLUC CROSS BLUE SHIELD