Healthcare Provider Details

I. General information

NPI: 1831738558
Provider Name (Legal Business Name): LARA SOPHIA SCHOENEBECK MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2019
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 OLIVE CHAPEL RD STE 107
APEX NC
27502-8587
US

IV. Provider business mailing address

4705 UNIVERSITY DR BLDG 700
DURHAM NC
27707-3489
US

V. Phone/Fax

Practice location:
  • Phone: 919-267-5862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012654
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: