Provider Demographics
NPI:1447272620
Name:STEVENS, ANGELINA VALERIE (DC)
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:VALERIE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 MARTIN LUTHER KING PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3586
Mailing Address - Country:US
Mailing Address - Phone:919-140-1506
Mailing Address - Fax:919-401-8253
Practice Address - Street 1:1802 MARTIN LUTHER KING PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3586
Practice Address - Country:US
Practice Address - Phone:919-140-1506
Practice Address - Fax:919-401-8253
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3162111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0194LOtherBC/BS