Provider Demographics
NPI:1982245304
Name:STEVENS, NATALIE BROOKE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:BROOKE
Last Name:STEVENS
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 1:6515 AUBURN TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-1677
Mailing Address - Country:US
Mailing Address - Phone:713-213-4596
Mailing Address - Fax:
Practice Address - Street 1:6515 AUBURN TERRACE LN
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-1677
Practice Address - Country:US
Practice Address - Phone:713-213-4596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide