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General NPI Number Information
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NPI Number | 1881383636
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Entity Type | Individual
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Provider Name | JENNIFER LYNN STOCKWELL FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/05/2023
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 511 RUIN CREEK RD STE 101
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City | HENDERSON
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State | NC
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Zip | 27536-5919
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Country | US
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Telephone | 252-436-0440
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 SUNSET RD
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City | OXFORD
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State | NC
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Zip | 27565-8498
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Country | US
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Telephone | 336-583-8173
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | STOC-M3Y3M
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License Number State | NC
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