Stevens, Larry Michael
Stevens, Larry Michael is an individual health care provider with primary practice located at 408 N State Of Franklin Rd Suite 24, Johnson City TN 37604-6089. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as his primary health care specialty. Stevens, Larry Michael can be contacted via phone (423) 431-1810.Contact Information
Primary practice address
408 N State Of Franklin Rd Suite 24
Johnson City TN 37604-6089
Phone: (423) 431-1810
Fax: (423) 431-1811
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 13439 | Tennessee |
Profile Details
| NPI number | 1053567826 |
|---|---|
| LBN Legal business name | Stevens, Larry Michael |
| Credentials | Advanced Practice Nurse (APN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2008 |
| Last updated | Feb 23rd, 2017 - about 9 years ago |
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 | 1053567826 | NPPES |
| Virginia | MEDICAID | 1053567826 | |
| Virginia | MEDICAID | 1053567826 | |
| Virginia | MEDICAID | 7100117150 | |
| Virginia | MEDICAID | 1507311 |
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