Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stephanie Nickerson, NP

Individual provider Nurse Practitioner · NPI 1982966206

Stephanie Nickerson, NP is a Nurse Practitioner in Roanoke, Virginia. Qualified in 2012, 14 years ago. Practices with Carilion Healthcare Corporation, a 549-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota, Texas and Virginia.

Years since qualifying
14
Licensed in
MN, TX, VA
In the registry since
2012
Specialties on file
4
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

3 Riverside Cir
Roanoke, VA 24016-4955
Phone: (540) 224-5170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 0024177488 (VA)
Nurse Practitioner Taxonomy 363L00000X · Licence 0024177488 (VA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence AP131784 (TX)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 207247-6 (MN)

Record details

NPI number1982966206
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJune 12, 2012
Last updated in NPPESMay 9, 2025
Certification dateMay 9, 2025
Mailing address213 S Jefferson St Ste 1006, Roanoke, VA 24011-1713

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Carilion Healthcare Corporation — 549 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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