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General NPI Number Information
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NPI Number | 1164663092
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Entity Type | Individual
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Provider Name | STEPHANIE MICHELLE LEVAN ELBEL MMS, PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 702 N MAIN ST
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City | ROXBORO
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State | NC
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Zip | 27573-4755
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Country | US
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Telephone | 336-599-9271
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Fax | 336-599-0347
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Provider Business Mailing Address
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Address Line | 702 N MAIN ST
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City | ROXBORO
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State | NC
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Zip | 27573-4755
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Country | US
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Telephone | 336-599-9271
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Fax | 336-599-0347
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-01728
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License Number State | NC
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