Individual
MS. STACEY ANN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 667-7000
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 662-7500
(910) 662-7501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5015071
NC
363LA2100X
Acute Care Nurse Practitioner
BRAD-DDBS5
NC
Other
Enumeration date
09/15/2021
Last updated
11/24/2021
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