Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | P19570 | NC |
NPI | 1063020337 |
---|---|
Provider Name | Nicholle Gabrielle Stein |
First Address | Durham, NC 27705-3984 |
Second Address | Durham, NC 27705-4699 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2020 |
Last Update Date | 22/07/2020 |