Provider Demographics
NPI:1437752151
Name:STEVENS, JAVINA L
Entity Type:Individual
Prefix:MS
First Name:JAVINA
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JAVINA
Other - Middle Name:LANAY
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1355 LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1544
Mailing Address - Country:US
Mailing Address - Phone:857-247-2493
Mailing Address - Fax:
Practice Address - Street 1:1355 LOUIS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1544
Practice Address - Country:US
Practice Address - Phone:857-247-2493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant