Provider Demographics
NPI:1447796362
Name:STEVENS, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7851 METRO PKWY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1567
Mailing Address - Country:US
Mailing Address - Phone:952-500-9338
Mailing Address - Fax:
Practice Address - Street 1:7851 METRO PKWY
Practice Address - Street 2:SUITE 225
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1567
Practice Address - Country:US
Practice Address - Phone:952-500-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologist