STEVELYNN J. POGUE GNP NPI 1245214808

NPI Information

NPI: 1245214808
Provider Name: STEVELYNN J. POGUE, GNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Address:
9202 ELAM RD
SOUTHEAST DALLAS HEALTH CENTER
DALLAS, TX
ZIP 75217
Phone: (214) 266-1600
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Stevelynn J. Pogue, GNP is a gerontology nurse practitioner in Dallas, TX. Stevelynn J. Pogue, GNP NPI is 1245214808. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9202 ELAM RD
SOUTHEAST DALLAS HEALTH CENTER
DALLAS, TX
ZIP 75217-151
Phone: (214) 266-1600

The enumeration date for this NPI number is 12/6/2005 and was last updated on 7/25/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	416332	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	138907412	MEDICAID	TEXAS
2	138907405	MEDICAID	TEXAS
3	138907403	MEDICAID	TEXAS
4	86N655	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
5	138907410	MEDICAID	TEXAS
6	138907404	MEDICAID	TEXAS
7	138907406	MEDICAID	TEXAS
8	138907407	MEDICAID	TEXAS
9	138907411	MEDICAID	TEXAS
10	138907408	MEDICAID	TEXAS
11	138907402	MEDICAID	TEXAS
12	500029400	OTHER	TEXAS	RAILROAD MEDICARE
13	S81290	MEDICARE UPIN	TEXAS
14	8Y0754	OTHER	TEXAS	BLUE CROSS BLUE SHIELD
15	138907401	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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