Provider Demographics
NPI:1992115083
Name:NEKITA STEVENSON
Entity type:Organization
Organization Name:NEKITA STEVENSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-596-8158
Mailing Address - Street 1:PO BOX 14346
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-1346
Mailing Address - Country:US
Mailing Address - Phone:912-596-8158
Mailing Address - Fax:404-601-9627
Practice Address - Street 1:3025 BULL ST
Practice Address - Street 2:SUITE 249
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-2016
Practice Address - Country:US
Practice Address - Phone:912-596-8158
Practice Address - Fax:404-601-9627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health