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Individual

MS. STACY LYNN STREET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2401 LARKSPUR DRIVE, GREENSBORO, NC 27405-5431
(336) 212-2730
Mailing address
2401 LARKSPUR DRIVE, GREENSBORO, NC 27405-5431
(336) 212-2730

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
NC
374U00000X
Home Health Aide
Primary
NC
376K00000X
Nurse's Aide
NC

Other

Enumeration date
08/18/2014
Last updated
08/18/2014
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