Individual
STACEY ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-4000
Mailing address
1632 BOROS DR, FAYETTEVILLE, NC 28303-3091
(910) 261-9241
Taxonomy
Speciality
Code
Description
License number
State
163WC3500X
Cardiac Rehabilitation Registered Nurse
Primary
307585
NC
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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