Provider Demographics
NPI:1023406329
Name:STEVENSON, CHRISTINA L (DNP, ANP-C,FNP-C, P)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:L
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:DNP, ANP-C,FNP-C, P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5540 CENTERVIEW DR STE 200
Mailing Address - Street 2:STE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606
Mailing Address - Country:US
Mailing Address - Phone:919-899-0759
Mailing Address - Fax:915-321-1706
Practice Address - Street 1:1890 S. MAIN STREET
Practice Address - Street 2:SUITES 102E, 102C
Practice Address - City:WAKEFOREST
Practice Address - State:NC
Practice Address - Zip Code:27587
Practice Address - Country:US
Practice Address - Phone:919-899-0759
Practice Address - Fax:919-321-1706
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007400363LA2200X, 363LF0000X, 363LP0808X
MDAC002915363LA2200X
MN5853363LA2200X, 363LF0000X
VA0024181480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily