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:
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Health care specialties

SpecialtyCodeLicense #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 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053567826 NPPES
Virginia MEDICAID 1053567826
Virginia MEDICAID 1053567826
Virginia MEDICAID 7100117150
Virginia MEDICAID 1507311

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