Basic Information
| Provider Information | |||||||||
| NPI: | 1285986745 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHOUTEN | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | HANNON | ||||||||
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| Credential: | N. P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3620 BRIDGETON PARK DR | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276124153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016345139 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 MANNING DR OFC BUILDING | ||||||||
| Address2: | CB# 7236 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275144221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199661178 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2012 | ||||||||
| LastUpdateDate: | 10/09/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 227870 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.