| Doctor Name: | MRS. STACI AVERY WOOD |
| NPI Number: | 1073824660 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 188963 |
| Business Practice Address: | 20 Durham St Southport, NC - 284619327 |
| Business Phone Number: | 9103051532 |
| Business Fax Number: | |
| Mailing Address: | 20 Durham St, SOUTHPORT |
| State: | NC |
| Postal Code: | 284619327 |
| Phone Number: | 9103051532 |
| Fax Number: | |
| NPI Enumeration Date: | 06/29/2010 |
| NPI Last Update Date: | 06/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WN0002X |
| License Number: | 188963 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Neonatal Intensive Care |
| Taxonomy Definition: | |