Healthcare Provider Details

I. General information

NPI: 1932977352
Provider Name (Legal Business Name): STEPHANIE ELIZABETH FOX APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 GODWIN BLVD STE 360
SUFFOLK VA
23434-8153
US

IV. Provider business mailing address

2790 GODWIN BLVD STE 360
SUFFOLK VA
23434-8153
US

V. Phone/Fax

Practice location:
  • Phone: 757-261-8070
  • Fax: 757-995-7095
Mailing address:
  • Phone: 757-261-8070
  • Fax: 757-995-7095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024191088
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0035543
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5019428
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019428
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: