Provider Demographics
NPI:1275500555
Name:STEVERDING, AMY MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:STEVERDING
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 1:30248 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-4818
Mailing Address - Country:US
Mailing Address - Phone:440-516-1776
Mailing Address - Fax:440-516-1277
Practice Address - Street 1:30248 HARRISON ST
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-4818
Practice Address - Country:US
Practice Address - Phone:440-516-1776
Practice Address - Fax:440-516-1277
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 218824163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2205358Medicaid