Provider Demographics
NPI:1033546536
Name:STEVENS, DEVAN (MS OTR, PA-C)
Entity Type:Individual
Prefix:
First Name:DEVAN
Middle Name:
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MS OTR, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 STIRRUP DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-8824
Mailing Address - Country:US
Mailing Address - Phone:702-578-6271
Mailing Address - Fax:
Practice Address - Street 1:901 RANCHO LN STE 135
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3826
Practice Address - Country:US
Practice Address - Phone:702-383-1958
Practice Address - Fax:702-383-8235
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV225XP0019X225XP0019X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation