Individual
STACIE GURGANUS FOUTTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8911 SHIPWATCH DR, WILMINGTON, NC 28412-3537
(252) 714-2509
Mailing address
8911 SHIPWATCH DR, WILMINGTON, NC 28412-3537
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5023013
NC
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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