Provider Demographics
NPI:1407826753
Name:STEVENS, LAURA (CNP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 DOVE CALL CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2867
Mailing Address - Country:US
Mailing Address - Phone:281-362-5646
Mailing Address - Fax:
Practice Address - Street 1:114 DOVE CALL CT
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2867
Practice Address - Country:US
Practice Address - Phone:281-362-5646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08171363L00000X
TX800706363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2598014Medicaid
PAMENP17523Medicare PIN
Q36109Medicare UPIN
OHMENP17521Medicare ID - Type Unspecified