Individual
STACIE RENEE' CORAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1585 3RD ST BLDG 285, FORT POLK, LA 71459-5102
(726) 780-2348
Mailing address
1585 3RD ST BLDG 285, FORT POLK, LA 71459-5102
(726) 780-2348
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN133540
LA
Other
Enumeration date
06/04/2026
Last updated
06/04/2026
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