Healthcare Provider Details

I. General information

NPI: 1639603681
Provider Name (Legal Business Name): STEPPING STONES COMMUNITY RESOURCES, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 06/11/2024
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 PARKWOOD BLVD W STE C
WILSON NC
27893-3679
US

IV. Provider business mailing address

1760 PARKWOOD BLVD W STE C
WILSON NC
27893-3679
US

V. Phone/Fax

Practice location:
  • Phone: 252-991-7010
  • Fax: 252-991-7011
Mailing address:
  • Phone: 252-991-7010
  • Fax: 252-991-7011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSICA NEWTON
Title or Position: OWNER
Credential:
Phone: 919-904-1909