Healthcare Provider Details

I. General information

NPI: 1760669758
Provider Name (Legal Business Name): STEPHANIE SUE TURPIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE CONOVER

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 02/08/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HARGETT ST
JACKSONVILLE NC
28540-5933
US

IV. Provider business mailing address

PO BOX 308
BENTON TN
37307-0308
US

V. Phone/Fax

Practice location:
  • Phone: 910-219-1082
  • Fax:
Mailing address:
  • Phone: 423-338-8995
  • Fax: 423-338-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13538
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5015656
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: