STACEY KATHRYN PRUDICH

WAKE FOREST, NC
NPI1831806017
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: NC  5017148)
Additional Taxonomies363LP0200X Nurse Practitioner, Pediatrics
(Licence: NC  PRUD-6TDQL)
Enumeration Date2022-10-28
Last Update Date2022-10-29
Business Address
STACEY KATHRYN PRUDICH
3000 ROGERS RD STE 210
WAKE FOREST, NC 27587-5745
Phone number: 919-385-2120
Mailing Address
STACEY KATHRYN PRUDICH
1501 BLOOMINGDALE DR
CARY, NC 27511-5955
Phone number: 919-357-4713