Provider Demographics
NPI:1699867978
Name:STEVENSON, CATHERINE J (ARNP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:J
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 SCANDIA AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-3659
Mailing Address - Country:US
Mailing Address - Phone:515-229-7091
Mailing Address - Fax:515-266-3105
Practice Address - Street 1:2679 MAURY ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50317-7462
Practice Address - Country:US
Practice Address - Phone:515-244-6162
Practice Address - Fax:515-266-3105
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA069714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily