Healthcare Provider Details

I. General information

NPI: 1548307507
Provider Name (Legal Business Name): VEE SUZANNE STONIKINIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 N ROAD ST
ELIZABETH CITY NC
27909-3353
US

IV. Provider business mailing address

104 ORCHARD DR
ELIZABETH CITY NC
27909-9336
US

V. Phone/Fax

Practice location:
  • Phone: 252-384-4101
  • Fax:
Mailing address:
  • Phone: 252-384-4662
  • Fax: 252-384-4574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number200747
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: