Healthcare Provider Details

I. General information

NPI: 1861738395
Provider Name (Legal Business Name): STEPHANIE HALEY NORTON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE NICOLE HALEY

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 FALLS OF NEUSE RD
RALEIGH NC
27614-7838
US

IV. Provider business mailing address

1172 DUKE FARM DR
WAKE FOREST NC
27587-7053
US

V. Phone/Fax

Practice location:
  • Phone: 919-350-8000
  • Fax:
Mailing address:
  • Phone: 336-479-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number178159
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1684
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: