Individual
JERRY BOYD STOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2817 REILLY ST, FORT BRAGG, NC 28310-7324
(910) 907-6888
Mailing address
47 LAUREL DR, SPRING LAKE, NC 28390-7375
(910) 644-6554
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
156164
NC
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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