Healthcare Provider Details

I. General information

NPI: 1144146861
Provider Name (Legal Business Name): STEPHANIE PAIGE DIAZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 MCCLELLAN BLVD
ANNISTON AL
36201-2132
US

IV. Provider business mailing address

170 STOLLIE FARM RD
ASHVILLE AL
35953-5895
US

V. Phone/Fax

Practice location:
  • Phone: 205-409-2794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1-169739
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: