Provider Demographics
NPI:1730477118
Name:STEVENS, ADEBOLA (RN)
Entity Type:Individual
Prefix:MISS
First Name:ADEBOLA
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 METROPOLITAN OVAL
Mailing Address - Street 2:APT. 8E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6440
Mailing Address - Country:US
Mailing Address - Phone:718-863-5702
Mailing Address - Fax:
Practice Address - Street 1:63 METROPOLITAN OVAL
Practice Address - Street 2:APT. 8E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6440
Practice Address - Country:US
Practice Address - Phone:718-863-5702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY643789-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse