Provider Demographics
NPI:1114207065
Name:ALVIS, STEFANIE MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:MARIE
Last Name:ALVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:STEFANIE
Other - Middle Name:MARIE
Other - Last Name:NEEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:108 DORNACH WAY
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-7305
Mailing Address - Country:US
Mailing Address - Phone:336-940-2407
Mailing Address - Fax:336-940-2406
Practice Address - Street 1:108 DORNACH WAY
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-7305
Practice Address - Country:US
Practice Address - Phone:336-940-2407
Practice Address - Fax:336-940-2406
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05137363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical