1689744302 NPI number — MRS. EMILY LYNN STEWART STEVENS M.A., LLP

Table of content: MRS. EMILY LYNN STEWART STEVENS M.A., LLP (NPI 1689744302)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689744302 NPI number — MRS. EMILY LYNN STEWART STEVENS M.A., LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEWART STEVENS
Provider First Name:
EMILY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., LLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEWART
Provider Other First Name:
EMILY
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A., LLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689744302
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5877 LARKWOOD CT
Provider Second Line Business Mailing Address:
APT. 2B
Provider Business Mailing Address City Name:
KALAMAZOO
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49048-6640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-806-9571
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7920 KIRKLAND CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTAGE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-345-0669
Provider Business Practice Location Address Fax Number:
269-345-5354
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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