Individual
STACEY C BOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1661 DAVIE AVE, STATESVILLE, NC 28677-3519
(704) 495-2470
Mailing address
1661 DAVIE AVE, STATESVILLE, NC 28677-3519
(704) 495-2470
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
0024179203
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
5013293
NC
Other
Enumeration date
07/10/2020
Last updated
08/26/2021
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