MEDICARE: MRS. DEBORAH W STOKELY FAMILY NURSE PRACTIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0200468	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346463981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH W STOKELY FAMILY NURSE PRACTIT

Provider Business Mailing Address
First Line	:	104 RHODES AVENUE
Second Line	:
City	:	WINDSOR
State	:	NC
Zip	:	27983
Country	:	US
Telephone Number	:	252-794-3042
Fax Number	:	252-794-2911

Provider Business Practice Location Address
First Line	:	104 RHODES AVE
Second Line	:
City	:	WINDSOR
State	:	NC
Zip	:	27983-9656
Country	:	US
Telephone Number	:	252-794-3042
Fax Number	:	252-794-2911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	01/23/2019

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