Provider Demographics
NPI:1023289303
Name:STEVENS, SARAH RUTH (RN)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:RUTH
Last Name:STEVENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:RUTH
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:354 TYEE ST
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7657
Mailing Address - Country:US
Mailing Address - Phone:907-714-5870
Mailing Address - Fax:907-260-2629
Practice Address - Street 1:354 TYEE ST
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7657
Practice Address - Country:US
Practice Address - Phone:816-665-3356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK21562163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse