Basic Information
| Provider Information | |||||||||
| NPI: | 1578284311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | XAVIER | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | BROOKE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | APRN, DNP, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2333 TALL SAIL DR APT G | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294146567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8646163314 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 100 SPRINGHALL DR | ||||||||
| Address2: | |||||||||
| City: | GOOSE CREEK | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294455335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435728201 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2022 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 26376 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.