Provider Demographics
NPI:1942614151
Name:STEVENSON, YOLANDA EVETTE (RN)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:EVETTE
Last Name:STEVENSON
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 1:800 GRAND CONCOURSE
Mailing Address - Street 2:APARTMENT 4TS
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-3003
Mailing Address - Country:US
Mailing Address - Phone:347-563-6579
Mailing Address - Fax:
Practice Address - Street 1:800 GRAND CONCOURSE
Practice Address - Street 2:APARTMENT 4TS
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-3003
Practice Address - Country:US
Practice Address - Phone:347-563-6579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22-680586163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse