Individual
MARIAH CORBIN STANICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-4001
(336) 716-6674
(336) 716-9188
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-6674
(336) 716-9188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5016428
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/10/2022
Last updated
06/30/2022
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