MEDICARE: MS. STEPHANIE MARIE ESTEVEZ 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
1	163W00000X	Registered Nurse	345232	NC
2	363LF0000X	Family Nurse Practitioner	5021431	NC

General Provider Information

NPI Number	:	1760291553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE MARIE ESTEVEZ NP

Provider Business Mailing Address
First Line	:	1317 LANDSDOWNE DR
Second Line	:
City	:	CONOVER
State	:	NC
Zip	:	28613-8922
Country	:	US
Telephone Number	:	828-994-7886
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 13TH AVENUE PL NW STE 120
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-2568
Country	:	US
Telephone Number	:	828-328-2941
Fax Number	:

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

Provider Enumeration Date	:	01/06/2025
Last Update Date	:	01/06/2025

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