Provider Demographics
NPI:1881585453
Name:STEVENSON, VICKY (LPN)
Entity type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 GOLDENSTAR LN
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-4324
Mailing Address - Country:US
Mailing Address - Phone:757-609-5859
Mailing Address - Fax:757-609-5859
Practice Address - Street 1:262 GOLDENSTAR LN
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-4324
Practice Address - Country:US
Practice Address - Phone:757-609-5859
Practice Address - Fax:757-609-5859
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002084460364SH0200X, 385H00000X, 251E00000X, 164W00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care