Healthcare Provider Details

I. General information

NPI: 1841870243
Provider Name (Legal Business Name): LINDSAY MICHELLE HEPHNER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY MICHELLE FUTRIS

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 BLUE RIDGE RD STE 300
RALEIGH NC
27607-6476
US

IV. Provider business mailing address

8496 CENTRAL DR
RALEIGH NC
27613-8587
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-7874
  • Fax:
Mailing address:
  • Phone: 919-522-8573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5014308
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: