Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5007400 | NC |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 5007400 | NC |
NPI | 1023406329 |
---|---|
Provider Name | Dr. Christina Lanette Stevenson |
First Address | Raleigh, NC 27610-6499 |
Second Address | Pineville, NC 28134-6528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2015 |
Last Update Date | 30/01/2018 |