Provider Demographics
NPI:1770050403
Name:STEVENS, SABRINA LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:LYNN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17410 HARRIS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62951-2421
Mailing Address - Country:US
Mailing Address - Phone:618-889-3817
Mailing Address - Fax:
Practice Address - Street 1:17410 HARRIS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:JOHNSTON CITY
Practice Address - State:IL
Practice Address - Zip Code:62951-2421
Practice Address - Country:US
Practice Address - Phone:618-889-3817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0363LF0000X
IN71008890A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily