Individual provider · NPI-1

Michael Brian Stevenson

Nurse Practitioner, Pediatrics · Duluth, MN

NPI number1164626859
StatusActive
Last updated in NPPESMay 2, 2011

Details

NPI
1164626859
Entity type
Individual (NPI-1)
Name
Michael Brian Stevenson
Sex
Male
Sole proprietor
No
Enumeration date
Jun 14, 2007
Last updated
May 2, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsR178540-5MNYes

Practice location

400 E 3rd St
Duluth, MN 55805-1951

Phone 218-786-3400

Mailing address

400 E 3rd St
Duluth, MN 55805-1951

Phone 218-786-3400

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