Individual
KELLY JO STOCKTON-DRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C,GNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5005167
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
5005167
NC
363LG0600X
Gerontology Nurse Practitioner
5005167
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19N0H
BCBS
NC
01
—
203866
RN LICENSE
NC
01
—
5005167
NP LICESNE
NC
05
—
7004895
—
NC
Enumeration date
05/13/2011
Last updated
03/07/2023
Update your record
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