Individual
STACY-ANN NICOLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
796 NANNYBERRY LN, CONCORD, NC 28025-9039
(252) 413-9604
(704) 469-6100
Mailing address
796 NANNYBERRY LN, CONCORD, NC 28025-9039
(252) 413-9604
(704) 469-6100
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
A-5962
NC
Other
Enumeration date
06/02/2010
Last updated
09/26/2011
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