Individual
STACEY JO EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3333 BROOKVIEW HILLS BLVD STE 204, WINSTON SALEM, NC 27103-5661
(336) 774-3740
(336) 774-3780
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5014063
NC
363LF0000X
Family Nurse Practitioner
5014063
NC
Other
Enumeration date
02/08/2021
Last updated
12/29/2021
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