TIMOTHY KYLE STACKS

CAMP LEJEUNE, NC
NPI1447224936
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: NC  149855)
Enumeration Date2006-02-14
Last Update Date2007-07-08
Business Address
TIMOTHY KYLE STACKS CRNA
100 BREWSTER BLVD NAVAL HOSPITAL CAMP LEJEUNE
CAMP LEJEUNE, NC 28547-2538
Phone number: 910-450-4791
Mailing Address
TIMOTHY KYLE STACKS CRNA
100 DOCKSIDE DR
JACKSONVILLE, NC 28546-9768
Phone number: 910-353-7509
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