Provider Demographics
NPI:1972129864
Name:CHAVIS, STEPHANIE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:CHAVIS
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 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:910-215-4111
Mailing Address - Fax:
Practice Address - Street 1:4901 DAWN DR STE 3200
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-8288
Practice Address - Country:US
Practice Address - Phone:910-735-8040
Practice Address - Fax:910-735-8045
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily