Provider Demographics
NPI:1184054983
Name:TAYLOR STEVENS, MARCIA LAVERNE (FNP)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:LAVERNE
Last Name:TAYLOR STEVENS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N GLYNN ST
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-5011
Mailing Address - Country:US
Mailing Address - Phone:478-445-3033
Mailing Address - Fax:
Practice Address - Street 1:800 N GLYNN ST
Practice Address - Street 2:ITU AT MILLEDGEVILLE
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-5011
Practice Address - Country:US
Practice Address - Phone:478-445-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAP-NP RN093986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily