Individual
STELLA OZOH WALSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP/PMHNP
Contact information
Practice address
175 KIMEL PARK DR, STE 100, WINSTON SALEM, NC 27103-6951
(336) 277-1800
(336) 277-6981
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-1800
(336) 277-6981
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5002035
NC
363LF0000X
Family Nurse Practitioner
0024166959
VA
363LF0000X
Family Nurse Practitioner
0050-02035
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5002035
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010286000
—
VA
05
—
7003836
—
NC
Enumeration date
06/09/2006
Last updated
08/02/2024
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