Individual
STACIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 S MAIN ST UNIT B, WEAVERVILLE, NC 28787-8463
(828) 484-8440
(828) 484-8445
Mailing address
10 S MAIN ST UNIT B, WEAVERVILLE, NC 28787-8463
(828) 484-8440
(828) 484-8445
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
3184
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601780
—
NC
05
—
6601812
—
NC
Enumeration date
06/11/2008
Last updated
12/28/2010
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