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Stacey Kathryn Prudich
Pediatric Nurse Practitioner in Wake Forest, North Carolina
NPI 1831806017

Stacey Kathryn Prudich is a Pediatric Nurse Practitioner based in Cary, NC and is specialized in Pediatrics. Stacey Kathryn Prudich practices in Wake Forest, NC. The NPI Number for Stacey Kathryn Prudich is 1831806017 and holds a License No. PRUD-6TDQL (North Carolina).

The current practice location address for Stacey Kathryn Prudich is 3000 Rogers Rd Ste 210, Wake Forest, NC and can be reached out via phone at 919-385-2120.

Location: 3000 Rogers Rd Ste 210, Wake Forest, NC, 27511-5955
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1831806017
Provider Name
Stacey Kathryn Prudich
Credential
Provider Entity Type
Individual
Gender
Female
Address
3000 Rogers Rd Ste 210, Wake Forest, NC, 27511-5955
Phone Number
919-385-2120
Fax Number
Provider Enumeration Date
10/28/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3000 Rogers Rd Ste 210
City
Wake Forest
State
North Carolina
Zip
27587-5745
Phone Number
919-385-2120
Fax Number
person
Provider Business Mailing Address Details
Address
3000 Rogers Rd Ste 210
City
Wake Forest
State
North Carolina
Zip
27587-5745
Phone Number
919-385-2120
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
PRUD-6TDQL (North Carolina)
Definition
Definition to come...
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