Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 5008784 | NC |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 25392 | SC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5008784 | NC |
NPI | 1316490733 |
---|---|
Provider Name | Stephanie M Neal |
First Address | Charlotte, NC 28260-2108 |
Second Address | Charleston, SC 29425-6150 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2016 |
Last Update Date | 01/11/2021 |