Provider Demographics
NPI:1437971439
Name:STEVENSON, MARYANN YEMA (MSN, RN)
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:YEMA
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9629 CHAPELCROFT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-3908
Mailing Address - Country:US
Mailing Address - Phone:702-340-8248
Mailing Address - Fax:
Practice Address - Street 1:9629 CHAPELCROFT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-3908
Practice Address - Country:US
Practice Address - Phone:702-340-8248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN627243163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator