Provider Demographics
NPI:1437422235
Name:STIVERSON, ALICIA CHRISTINE (PA)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:CHRISTINE
Last Name:STIVERSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 VERNON PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2425
Mailing Address - Country:US
Mailing Address - Phone:513-872-4555
Mailing Address - Fax:513-872-7625
Practice Address - Street 1:2925 VERNON PL
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2425
Practice Address - Country:US
Practice Address - Phone:513-872-4555
Practice Address - Fax:513-872-7625
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50003483363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant