Doctor Name: | STACI G. STREETER-MOYE |
NPI Number: | 1003148867 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | 5004620 |
Business Practice Address: | 511 Paladin Dr Greenville, NC - 278347826 |
Business Phone Number: | 2527528880 |
Business Fax Number: | 2527523084 |
Mailing Address: | 511 Paladin Drive, Eastern Nephrology Associates, Pllc GREENVILLE |
State: | NC |
Postal Code: | 278347826 |
Phone Number: | 2527528880 |
Fax Number: | 2527523084 |
NPI Enumeration Date: | 02/04/2010 |
NPI Last Update Date: | 09/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 5004620 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |