Provider Demographics
NPI:1316147507
Name:STEVENS, DARLA RAE (FNP-C)
Entity type:Individual
Prefix:
First Name:DARLA
Middle Name:RAE
Last Name:STEVENS
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 1:2858 HARMON RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-0623
Mailing Address - Country:US
Mailing Address - Phone:980-241-1379
Mailing Address - Fax:
Practice Address - Street 1:420 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5033
Practice Address - Country:US
Practice Address - Phone:828-315-5622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201209363LF0000X
NC135883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1316147507Medicaid
SCNP1897Medicaid
NC7004576Medicaid
NC1316147507Medicaid
NCNC7795AMedicare PIN