Individual
TAMRA STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 BUTLER AVE, MARTINSBURG, WV 25405-9990
(304) 263-0811
Mailing address
510 BUTLER AVE, MARTINSBURG, WV 25405-9990
(304) 263-0811
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
54634
WV
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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