Healthcare Provider Details

I. General information

NPI: 1265214324
Provider Name (Legal Business Name): STEPHANIE LINETTE MERRITT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2023
Last Update Date: 10/13/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 SPRINGWOOD DR NE
VALDESE NC
28690-8710
US

IV. Provider business mailing address

1226 PINE GROVE RD
MORGANTON NC
28655-8507
US

V. Phone/Fax

Practice location:
  • Phone: 828-879-8419
  • Fax:
Mailing address:
  • Phone: 828-781-7516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019005
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: