Provider Demographics
NPI:1972888477
Name:STEVENS, ARLIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:ARLIE
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 S COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3610
Mailing Address - Country:US
Mailing Address - Phone:478-307-0880
Mailing Address - Fax:478-307-0890
Practice Address - Street 1:355 S COLEMAN ST
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3610
Practice Address - Country:US
Practice Address - Phone:478-307-0880
Practice Address - Fax:478-307-0890
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN235270163WX0200X, 163W00000X, 363L00000X
GALPN071664164W00000X
AL2-060549164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0200XNursing Service ProvidersRegistered NurseOncology
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse