Provider Demographics
NPI:1285799130
Name:CHRISTINE, STEPHANIE COLETTE (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:COLETTE
Last Name:CHRISTINE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:COLETTE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:888-339-6065
Mailing Address - Fax:855-538-4441
Practice Address - Street 1:1998 HENDERSONVILLE RD STE 53
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2192
Practice Address - Country:US
Practice Address - Phone:828-585-5489
Practice Address - Fax:855-308-2340
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-11009363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-11009OtherNORTH CAROLINA STATE PHYSICIAN ASSISTANT LICENSE
1073457OtherNCCPA