Individual
QUANTAYJIA SHANAY WILFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 SMOKETREE WAY, LOUISBURG, NC 27549-2165
(919) 496-2188
Mailing address
932 GREEN GABLE DR, ZEBULON, NC 27597-4436
(252) 661-0964
(252) 661-0964
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
315345
NC
363L00000X
Nurse Practitioner
Primary
5025004
NC
Other
Enumeration date
06/19/2026
Last updated
07/31/2026
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