Individual
LORI NICOLE STOGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2761 AGNES LN, MYRTLE BEACH, SC 29577-2029
(843) 492-2710
(843) 492-2708
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4128
SC
Other
Enumeration date
09/24/2021
Last updated
11/04/2024
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