Provider Demographics
NPI:1093482929
Name:STEVENSON, SARAH WEAVER (AGACNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:WEAVER
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:923 BYRNE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-7107
Mailing Address - Country:US
Mailing Address - Phone:904-708-2889
Mailing Address - Fax:
Practice Address - Street 1:6560 FANNIN ST STE 2206
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2726
Practice Address - Country:US
Practice Address - Phone:713-790-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1052485363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care