Individual
MRS. STACI AVERY WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
20 DURHAM ST, SOUTHPORT, NC 28461-9327
(910) 305-1532
Mailing address
20 DURHAM ST, SOUTHPORT, NC 28461-9327
(910) 305-1532
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
188963
NC
163WN0002X
Neonatal Intensive Care Registered Nurse
188963
NC
163WN0003X
Low-Risk Neonatal Registered Nurse
188963
NC
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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