Provider Demographics
NPI:1679935548
Name:STEVENS, SONDRA FALICIA
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:FALICIA
Last Name:STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4426
Mailing Address - Country:US
Mailing Address - Phone:901-308-2226
Mailing Address - Fax:901-590-2883
Practice Address - Street 1:4646 POPLAR AVE STE 530
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4435
Practice Address - Country:US
Practice Address - Phone:901-308-2226
Practice Address - Fax:901-590-2883
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty