Individual
STACEY JEFFERSON COATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4610 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3520
(336) 713-7251
(336) 713-0306
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-7251
(336) 713-0306
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5014821
NC
Other
Enumeration date
08/02/2021
Last updated
10/02/2023
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