Healthcare Provider Details

I. General information

NPI: 1326699687
Provider Name (Legal Business Name): JANEE ALEXANDRIA STEVENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

IV. Provider business mailing address

622 RIDGEVIEW RD
LEASBURG NC
27291-8939
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-1000
  • Fax:
Mailing address:
  • Phone: 469-671-7544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number280088
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024178291
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: