Provider Demographics
NPI:1205041084
Name:SENEGAL, STEPHANNIE COOPER (FNP)
Entity Type:Individual
Prefix:MS
First Name:STEPHANNIE
Middle Name:COOPER
Last Name:SENEGAL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:STEPHANNIE
Other - Middle Name:COOPER
Other - Last Name:SENEGAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:217 TRILLINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3035
Mailing Address - Country:US
Mailing Address - Phone:919-212-7210
Mailing Address - Fax:919-212-7946
Practice Address - Street 1:10 SUNNYBROOK ROAD SUITE 362
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1834
Practice Address - Country:US
Practice Address - Phone:919-212-7210
Practice Address - Fax:919-212-7946
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106380363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health