Healthcare Provider Details

I. General information

NPI: 1558289801
Provider Name (Legal Business Name): AMBER LANIER STEVENS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 N QUEEN ST
KINSTON NC
28501-4932
US

IV. Provider business mailing address

101 ELLINGTON WAY
LA GRANGE NC
28551-7767
US

V. Phone/Fax

Practice location:
  • Phone: 252-522-9800
  • Fax:
Mailing address:
  • Phone: 919-432-8033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5025363
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: