Individual
STACIE DIETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3643 N ROXBORO ST, DURHAM, NC 27704-2702
(919) 470-4220
Mailing address
7711 CAPE CHARLES DR, RALEIGH, NC 27617-8321
(919) 257-9969
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
223493
NC
176B00000X
Midwife
Primary
666
NC
Other
Enumeration date
10/03/2017
Last updated
03/17/2018
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