Provider Demographics
NPI:1134457351
Name:STEVENSON, PATRICIA CATHERINE (RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CATHERINE
Last Name:STEVENSON
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 1:11 LEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030-1811
Mailing Address - Country:US
Mailing Address - Phone:508-785-0065
Mailing Address - Fax:
Practice Address - Street 1:11 LEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:MA
Practice Address - Zip Code:02030-1811
Practice Address - Country:US
Practice Address - Phone:508-785-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258910163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse