Individual
STACEY LEE WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
34 GIFFORD ST, NEW BEDFORD, MA 02744-2610
(508) 642-8264
Mailing address
597 COGGESHALL ST, NEW BEDFORD, MA 02746-1431
(508) 642-8264
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN87643
MA
Other
Enumeration date
03/28/2013
Last updated
05/08/2021
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