MEDICARE: STEPHANIE NICOLE ROBERTS F.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5006190	NC

General Provider Information

NPI Number	:	1093057028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE NICOLE ROBERTS F.N.P.

Provider Business Mailing Address
First Line	:	2000 PERIMETER PARK DR STE 200
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 HOLLY SPRINGS RD STE 212
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-9469
Country	:	US
Telephone Number	:	919-552-1457
Fax Number	:	919-552-1369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2013
Last Update Date	:	08/09/2021

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