Provider Demographics
NPI:1467493981
Name:STONE, KAREN HOLT (RN, MSN, CNS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:HOLT
Last Name:STONE
Suffix:
Gender:F
Credentials:RN, MSN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 COURT SQ
Mailing Address - Street 2:STE A
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5677
Mailing Address - Country:US
Mailing Address - Phone:919-777-6786
Mailing Address - Fax:919-777-6786
Practice Address - Street 1:321 COURT SQ
Practice Address - Street 2:STE A
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5677
Practice Address - Country:US
Practice Address - Phone:919-777-6786
Practice Address - Fax:919-777-6786
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC056110364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6004012Medicaid