Individual provider Active NPI

Laurie Ellen Stevenson, NP

  • Nurse Practitioner
  • Kenai, AK
National Provider Identifier
1275644577
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
917 Issued in AK
Practice address
805 Frontage Rd
Suite 130
Kenai, AK 99611-7755
Phone
(907) 283-2231
Fax
(907) 283-4236
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 917 AK Primary

Addresses

Primary practice location

805 Frontage Rd
Suite 130
Kenai, AK 99611-7755

Mailing address

202 S Forest Dr
Apt #3
Kenai, AK 99611-7931
Phone (907) 398-9371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120809000950 AK Order and Referring Only - Nurse Practitioner 6103072996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
917AKMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1275644577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S FOREST DR",
            "address_2": "APT #3",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117931",
            "telephone_number": "907-398-9371",
            "fax_number": "907-283-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 FRONTAGE RD",
            "address_2": "SUITE 130",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117755",
            "telephone_number": "907-283-2231",
            "fax_number": "907-283-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "LAURIE",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

Verify at the official NPI Registry.