Healthcare Provider Details

I. General information

NPI: 1710139217
Provider Name (Legal Business Name): STEPHANIE LYNN HALL APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE LYNN GRETHER

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KILDAIRE PARK DR STE 402
CARY NC
27518-8144
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 855-501-1004
  • Fax:
Mailing address:
  • Phone: 920-720-3700
  • Fax: 920-720-3806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5019423
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: