Provider Demographics
NPI:1851813307
Name:STUBBLEFIELD, CAROLINE JUNE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:JUNE
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials: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:PO BOX 40098
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0098
Mailing Address - Country:US
Mailing Address - Phone:251-434-3473
Mailing Address - Fax:251-434-3757
Practice Address - Street 1:1660 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1405
Practice Address - Country:US
Practice Address - Phone:251-665-8000
Practice Address - Fax:251-665-8010
Is Sole Proprietor?:No
Enumeration Date:2017-07-15
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-154699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1265478663Medicaid