Individual
MRS. STACEY RENEE KOONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-5094
(910) 615-5026
Mailing address
5029 NC HIGHWAY 87 S, FAYETTEVILLE, NC 28306-3391
(910) 578-0658
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
171953
NC
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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