Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 5004620 | NC |
NPI | 1003148867 |
---|---|
Provider Name | Staci G. Streeter-Moye |
First Address | Greenville, NC 27834-7826 |
Second Address | Greenville, NC 27834-7826 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2010 |
Last Update Date | 15/09/2015 |