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 |
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Provider Enumeration Date | 02/04/2022 |
Last Update Date | 04/17/2023 |
Certification Date | 04/17/2023 |
Medicare PECOS PAC ID | 3173916293 |
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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 |
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Provider Type | Practitioner - Sleep Medicine |
Provider Identifiers | NPI Number: 1811931231 PECOS PAC ID: 4385600428 Enrollment ID: I20060223000518 |
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