Provider Demographics
NPI:1033082599
Name:STEVENSON, KIRA JO
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:JO
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 1:1919 W 39TH ST APT B10
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2780
Mailing Address - Country:US
Mailing Address - Phone:308-320-8187
Mailing Address - Fax:
Practice Address - Street 1:1919 W 39TH ST APT B10
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2780
Practice Address - Country:US
Practice Address - Phone:308-320-8187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty