Individual
MS. STACEY LEIGH PSIKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 772-9202
(910) 772-9452
Mailing address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 772-9202
(910) 772-9452
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1109166
KY
367500000X
Certified Registered Nurse Anesthetist
050645
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
151034
NC
Other
Enumeration date
06/01/2006
Last updated
03/17/2021
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