Provider Demographics
NPI:1831662337
Name:STEVENSON, SEANNA PAIGE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:SEANNA
Middle Name:PAIGE
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-2102
Mailing Address - Country:US
Mailing Address - Phone:660-826-4774
Mailing Address - Fax:660-827-8992
Practice Address - Street 1:1109 W CLAY RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:MO
Practice Address - Zip Code:65084-1177
Practice Address - Country:US
Practice Address - Phone:573-378-2349
Practice Address - Fax:866-208-0157
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018363LF0000X
MO2018034767363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily