Healthcare Provider Details

I. General information

NPI: 1780669069
Provider Name (Legal Business Name): STEPHANIE ROBBINS NIX M.S, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MOREHEAD MEDICAL ST SUITE 500
CHARLOTTE NC
28204-2839
US

IV. Provider business mailing address

3483 NESTLING LN
FORT MILL SC
29708-7835
US

V. Phone/Fax

Practice location:
  • Phone: 704-355-6089
  • Fax:
Mailing address:
  • Phone: 803-547-5961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: