Individual
JULIANNE P STASKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-2676
Mailing address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-1626
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08079
NC
363AM0700X
Medical Physician Assistant
7112
NY
Other
Enumeration date
01/21/2007
Last updated
03/29/2021
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