Stevens, Mary Lou

Stevens, Mary Lou is an individual health care provider with primary practice located at 750 Wellington Ave , Grand Junction CO 81501-6132. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Stevens, Mary Lou can be contacted via phone (970) 244-2457.

Contact Information

Primary practice address
750 Wellington Ave Grand Junction CO 81501-6132
Phone: (970) 244-2457
Fax: (970) 255-1809
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2119 Colorado

Profile Details

NPI number 1114903168
LBN Legal business name Stevens, Mary Lou
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2005
Last updated Jun 18th, 2009 - about 16 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 1114903168 NPPES
Colorado MEDICAID 88500268

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