Individual
STEPHANIE WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-1461
(336) 713-5215
(336) 716-0030
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-5215
(336) 716-0030
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
NJ00327500
NJ
164W00000X
Licensed Practical Nurse
NR13231200
NJ
363L00000X
Nurse Practitioner
Primary
5014743
NC
363LF0000X
Family Nurse Practitioner
26NJ00327500
NJ
Other
Enumeration date
07/18/2011
Last updated
08/06/2021
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