Provider Demographics
NPI:1891329959
Name:STEVENSON, MARGARET TAYLOR
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:TAYLOR
Last Name:STEVENSON
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 1:9302 VILLA FAIR CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-1493
Mailing Address - Country:US
Mailing Address - Phone:502-909-5183
Mailing Address - Fax:
Practice Address - Street 1:9302 VILLA FAIR CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-1493
Practice Address - Country:US
Practice Address - Phone:502-909-5183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014410363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care