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Individual

SHIRLEY A STANLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
720 N PERSON ST, #106, RALEIGH, NC 27604-1277
(205) 307-9200
Mailing address
720 N PERSON ST, #106, RALEIGH, NC 27604-1277
(205) 307-9200

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1024857
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000073806
AL
01
430017465
RR MEDICARE
AL
01
430063126
RR MEDICARE
AL
05
APPROVED 07/13/2011;
NC
Enumeration date
08/09/2006
Last updated
09/05/2011
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