Individual
STEPHANIE KATHERINE LASTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
201 E ACADEMY ST, FUQUAY VARINA, NC 27526-2248
(910) 390-0363
(315) 496-7529
Mailing address
201 E ACADEMY ST, FUQUAY VARINA, NC 27526-2248
(910) 390-0363
(315) 496-7529
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5019168
NC
Other
Enumeration date
11/15/2023
Last updated
01/30/2024
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