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General NPI Number Information
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NPI Number | 1558275842
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Entity Type | Individual
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Provider Name | STEPHANIE THOMAS
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Gender | Female
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 603 MONAGAN ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-7024
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Country | US
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Telephone | 813-380-0228
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Fax |
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Provider Business Mailing Address
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Address Line | 272 PARADISE DR
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City | PORTSMOUTH
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State | VA
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Zip | 23701-2742
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Country | US
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Telephone | 813-380-0228
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Fax |
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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 | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | 61472
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License Number State | VA
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