Provider Demographics
NPI:1629180070
Name:STEVENS, VERONICA FREDERICK (FNP)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:FREDERICK
Last Name:STEVENS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:MRS
Other - First Name:VERONICA
Other - Middle Name:FREDERICK
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:361 SOUTH CARROLLS ROAD
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-7605
Mailing Address - Country:US
Mailing Address - Phone:910-293-2109
Mailing Address - Fax:
Practice Address - Street 1:340 SEMINARY STREET
Practice Address - Street 2:
Practice Address - City:KENANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28349-0948
Practice Address - Country:US
Practice Address - Phone:910-296-2130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily