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1083018030
STACEY LYNN CHILDRESS
CHARLESTON, SC
NPI
1083018030
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: SC 23153)
Enumeration Date
2014-10-20
Last Update Date
2022-05-31
Business Address
STACEY LYNN CHILDRESS AGPCNP
316 CALHOUN ST
CHARLESTON, SC 29401-1113
Phone number: 843-724-2450
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Mailing Address
STACEY LYNN CHILDRESS AGPCNP
PO BOX 751649
CHARLOTTE, NC 28275-1649
Phone number: 843-789-1620
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