Provider Demographics
NPI:1821188608
Name:STEVENS, JERI ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:JERI
Middle Name:ANN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:556 CHUKKER CV
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8683
Mailing Address - Country:US
Mailing Address - Phone:517-552-3864
Mailing Address - Fax:734-769-7056
Practice Address - Street 1:2215 FULLER RD
Practice Address - Street 2:VA ANN ARBOR HEALTHCARE SYSTEM
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2335
Practice Address - Country:US
Practice Address - Phone:734-769-7100
Practice Address - Fax:734-769-7056
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704188675363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704188675OtherRN LICENSURE
MI4704188675OtherRN LICENSURE