Healthcare Provider Details

I. General information

NPI: 1447968458
Provider Name (Legal Business Name): KRISTYN STEWART STEVENS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 TALLULAH RD
ROBBINSVILLE NC
28771
US

IV. Provider business mailing address

1695 W BUFFALO RD
ROBBINSVILLE NC
28771-7886
US

V. Phone/Fax

Practice location:
  • Phone: 828-479-6434
  • Fax:
Mailing address:
  • Phone: 828-735-3294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5017133
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: