Provider Demographics
NPI:1578284311
Name:XAVIER, STEPHANIE BROOKE (APRN, DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:BROOKE
Last Name:XAVIER
Suffix:
Gender:F
Credentials:APRN, DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 TALL SAIL DR APT G
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6567
Mailing Address - Country:US
Mailing Address - Phone:864-616-3314
Mailing Address - Fax:
Practice Address - Street 1:418 FOLLY RD STE A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2625
Practice Address - Country:US
Practice Address - Phone:843-795-5362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26376363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily