Provider Demographics
NPI:1740520402
Name:STEVISON, DEBORAH ANN (CNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:STEVISON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NORTH F ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013
Mailing Address - Country:US
Mailing Address - Phone:513-795-7557
Mailing Address - Fax:513-795-7518
Practice Address - Street 1:25 N F ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-3075
Practice Address - Country:US
Practice Address - Phone:513-795-7557
Practice Address - Fax:513-795-7518
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-14265363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0080015Medicaid
OH0080015Medicaid