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NPI Code Detail

MEDICARE: MRS. STEPHANIE LYNN BOONE NP

MEDICARE: MRS. STEPHANIE LYNN BOONE NP
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
1363LG0600XGerontology Nurse Practitioner5014550NC

General Provider Information

NPI Number : 1730757998
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE LYNN BOONE NP
Provider Business Mailing Address
First Line : 901 N WINSTEAD AVE
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-8467
Country : US
Telephone Number : 252-937-0200
Fax Number :
Provider Business Practice Location Address
First Line : 921 N WINSTEAD AVE
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-8749
Country : US
Telephone Number : 252-937-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2021
Last Update Date : 06/22/2021

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