| Stevens Sleep Clinic Llc | |
|
11881 W 112th St Overland Park KS 66210-2717 | |
| (913) 754-3275 | |
| Not Available |
| Full Name | Stevens Sleep Clinic Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11881 W 112th St, Overland Park, Kansas |
| Authorized Official Name and Position | Mary Suzanne Stevens (OWNER) |
| Authorized Official Contact | 9132445805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stevens Sleep Clinic Llc 6725 Longview Rd Shawnee KS 66218-9284 Ph: (913) 244-5805 | Stevens Sleep Clinic Llc 11881 W 112th St Overland Park KS 66210-2717 Ph: (913) 754-3275 |
| NPI Number | 1922752369 |
|---|---|
| Provider Enumeration Date | 02/04/2022 |
| Last Update Date | 04/17/2023 |
| Certification Date | 04/17/2023 |
| Medicare PECOS PAC ID | 3173916293 |
|---|---|
| Medicare Enrollment ID | O20220211001232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922752369 | NPI | - | NPPES |
| 1811931231 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | (* (Not Available)) | Primary |
| Provider Name | Mary Suzanne Stevens |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1811931231 PECOS PAC ID: 4385600428 Enrollment ID: I20060223000518 |
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