| Doctor Name: | STACIE LA JEUNESSE |
| NPI Number: | 1053447870 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | 300243 |
| Business Practice Address: | 2842 Neuse Blvd New Bern, NC - 285622839 |
| Business Phone Number: | 2525144770 |
| Business Fax Number: | 2525144773 |
| Mailing Address: | 202 Walden Ct, NEW BERN |
| State: | NC |
| Postal Code: | 285628993 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 300243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |