Provider Demographics
NPI:1639603681
Name:STEPPING STONES COMMUNITY RESOURCES, INCORPORATED
Entity Type:Organization
Organization Name:STEPPING STONES COMMUNITY RESOURCES, INCORPORATED
Other - Org Name:STEPPING STONES PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-269-9300
Mailing Address - Street 1:2519 AIRPORT BLVD NW
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-9603
Mailing Address - Country:US
Mailing Address - Phone:919-904-1909
Mailing Address - Fax:877-698-8894
Practice Address - Street 1:2519 AIRPORT BLVD NW
Practice Address - Street 2:SUITE C
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-9603
Practice Address - Country:US
Practice Address - Phone:919-904-1909
Practice Address - Fax:877-698-8894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261Q00000X
363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty