Individual
AMANDA A STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10628 PARK RD, CHARLOTTE, NC 28210-8407
(704) 667-1000
Mailing address
13706 APPLING LN, CHARLOTTE, NC 28278-8314
(704) 504-3154
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
080544
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8053533
—
NC
05
—
NAN907
—
SC
Enumeration date
08/26/2008
Last updated
01/22/2010
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