Provider Demographics
NPI:1033286208
Name:NANCE, STEPHANIE GARRETT (AUD, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:GARRETT
Last Name:NANCE
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-716-1331
Mailing Address - Fax:
Practice Address - Street 1:1132 N CHURCH ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1040
Practice Address - Country:US
Practice Address - Phone:336-379-9445
Practice Address - Fax:336-544-7180
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3421231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist