Provider Demographics
NPI:1588815658
Name:STEVENS, JENNIFER BOWERS
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BOWERS
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 1:11101 DOT
Mailing Address - Street 2:2200 CHILDRENS WAY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0005
Mailing Address - Country:US
Mailing Address - Phone:615-936-0249
Mailing Address - Fax:615-936-0256
Practice Address - Street 1:11101 DOT
Practice Address - Street 2:2200 CHILDRENS WAY
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0005
Practice Address - Country:US
Practice Address - Phone:615-936-0249
Practice Address - Fax:615-343-0256
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13654363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics