Provider Demographics
NPI:1184958001
Name:SONDERMANN-LUTHER, STEPHANIE LYNN (LPN, CLC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNN
Last Name:SONDERMANN-LUTHER
Suffix:
Gender:F
Credentials:LPN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6028 CHANCELLORSVILLE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-0009
Mailing Address - Country:US
Mailing Address - Phone:910-833-2143
Mailing Address - Fax:
Practice Address - Street 1:4712 NEW CENTRE DR STE 106
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3504
Practice Address - Country:US
Practice Address - Phone:910-769-6443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293977164W00000X
NC73468164W00000X
374J00000X
NC306794174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No374J00000XNursing Service Related ProvidersDoula