Provider Demographics
NPI:1548432404
Name:STOKESDALE FAMILY CARE, PC
Entity Type:Organization
Organization Name:STOKESDALE FAMILY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:DEBELL
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:336-644-0781
Mailing Address - Street 1:8302-B BELEWS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:STOKESDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27357-9203
Mailing Address - Country:US
Mailing Address - Phone:336-644-0781
Mailing Address - Fax:336-408-0784
Practice Address - Street 1:8302-B BELEWS CREEK RD
Practice Address - Street 2:
Practice Address - City:STOKESDALE
Practice Address - State:NC
Practice Address - Zip Code:27357-9203
Practice Address - Country:US
Practice Address - Phone:336-644-0781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty