Stevens, Kenneth
Stevens, Kenneth is an individual health care provider with primary practice located at 3268 Waterstone Ave , Henderson NV 89044-1867. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Phlebology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Stevens, Kenneth can be contacted via phone (815) 378-8514.Contact Information
Primary practice address
3268 Waterstone Ave
Henderson NV 89044-1867
Phone: (815) 378-8514
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Phlebology | 202K00000X | A102905 | California |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | A102905 | California |
Profile Details
| NPI number | 1184643629 |
|---|---|
| LBN Legal business name | Stevens, Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | May 5th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184643629 | NPPES |
| California | Other | A102905 | MEDICAL BOARD LICENSE |
| California | Other | 9136184 | MEDICAL BOARD LICENSE |
| California | Other | 0A1029050 | MEDICAL BOARD LICENSE |
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