Provider Demographics
NPI:1780641605
Name:STEVENS, MARGARET D (ARNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:D
Last Name:STEVENS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 FORT CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-9339
Mailing Address - Country:US
Mailing Address - Phone:270-885-8445
Mailing Address - Fax:270-885-1216
Practice Address - Street 1:4235 FORT CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-9339
Practice Address - Country:US
Practice Address - Phone:270-885-8445
Practice Address - Fax:270-886-9106
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2428P363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78002797Medicaid
KY000000343031OtherANTHEM
KY78002797Medicaid