Provider Demographics
NPI:1003035924
Name:STEVENS, KARLIE THOMASINA (RN)
Entity Type:Individual
Prefix:MRS
First Name:KARLIE
Middle Name:THOMASINA
Last Name:STEVENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 SAWMILL PL
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44904-1713
Mailing Address - Country:US
Mailing Address - Phone:419-632-7422
Mailing Address - Fax:
Practice Address - Street 1:1822 SAWMILL PL
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44904-1713
Practice Address - Country:US
Practice Address - Phone:419-632-7422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN274525163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health