Provider Demographics
NPI:1346463981
Name:STOKELY, DEBORAH W (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:W
Last Name:STOKELY
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 RHODES AVENUE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983
Mailing Address - Country:US
Mailing Address - Phone:252-794-3042
Mailing Address - Fax:252-794-2911
Practice Address - Street 1:104 RHODES AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-9656
Practice Address - Country:US
Practice Address - Phone:252-794-3042
Practice Address - Fax:252-794-2911
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0200468363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7000583Medicaid
NC2593080AMedicare PIN
NC2593080Medicare PIN