Individual
TAMMY WAITS STIMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
137 MEDICAL LN, POLLOCKSVILLE, NC 28573
(252) 633-1010
(252) 224-3071
Mailing address
PO BOX 68, POLLOCKSVILLE, NC 28573-0068
(252) 633-1010
(252) 224-0378
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201079
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11729
BLUE CROSS
NC
05
—
8911729
—
NC
Enumeration date
09/02/2005
Last updated
05/30/2018
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