Healthcare Provider Details

I. General information

NPI: 1942523113
Provider Name (Legal Business Name): STEPHANIE ST. HILAIRE- FELIX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 STEEL TRL
PENDERGRASS GA
30567-2400
US

IV. Provider business mailing address

25 STEEL TRL
PENDERGRASS GA
30567-2400
US

V. Phone/Fax

Practice location:
  • Phone: 347-898-4420
  • Fax:
Mailing address:
  • Phone: 347-898-4420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN316611
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: