Individual
STEPHANNY PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
200 TARPON TRL, JACKSONVILLE, NC 28546-5287
(910) 938-1114
(910) 938-1118
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5015948
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043978709
NPI
—
Enumeration date
11/30/2021
Last updated
01/03/2025
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