Healthcare Provider Details

I. General information

NPI: 1396664751
Provider Name (Legal Business Name): STEPHANIE LYNN ESTES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59664 HIGHWAY 22
ROANOKE AL
36274-4438
US

IV. Provider business mailing address

59664 HIGHWAY 22
ROANOKE AL
36274-4438
US

V. Phone/Fax

Practice location:
  • Phone: 334-863-8951
  • Fax: 334-863-2361
Mailing address:
  • Phone: 334-863-8951
  • Fax: 334-863-2361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-112152
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: