Nicole Renee Stevens, FNP-BC
Individual provider Active NPI General Practice Physician · Brunswick, MD
NPI 1225979586 · NPPES record last updated Apr 2, 2026
Key facts
- NPI
- 1225979586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- R275616 (MD)
- Practice address
- 655 Central Ave
Brunswick, MD 21716-1027 - Phone
- (571) 365-8035
- NPI assigned
- Apr 2, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R275616 | MD | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | R275616 | MD | Yes |
Addresses
Primary practice location
655 Central Ave
Brunswick, MD 21716-1027
Mailing address
655 Central Ave
Brunswick, MD 21716-1027
Phone (571) 365-8035
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All providers in Brunswick, MD · General Practice Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.