Provider Demographics
NPI:1306427802
Name:ROSS, STEPHANIE (CHES, NBC-HWC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:CHES, NBC-HWC
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 99427
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624-9427
Mailing Address - Country:US
Mailing Address - Phone:919-438-3188
Mailing Address - Fax:
Practice Address - Street 1:8604 CHEERFUL CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3802
Practice Address - Country:US
Practice Address - Phone:194-383-1889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator