Provider Demographics
NPI:1154073070
Name:STEVENS, DAYNA NICOLE (BSN, MSN, RN, FNP-C)
Entity type:Individual
Prefix:
First Name:DAYNA
Middle Name:NICOLE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:BSN, MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 OREGON BLVD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-3345
Mailing Address - Country:US
Mailing Address - Phone:734-536-6616
Mailing Address - Fax:
Practice Address - Street 1:9468 S SAGINAW RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-9668
Practice Address - Country:US
Practice Address - Phone:810-445-5500
Practice Address - Fax:810-445-5600
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704341710163WC0200X
MIF03240524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine