STACEY MARIE BRUNDRETT (NPI# 1174137756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174137756 |
| Entity Type | Individual |
| Full Name | STACEY MARIE BRUNDRETT |
| Credential | CNS |
| Practice Address |
120 Quail Hollow Dr Goldsboro NC 27534-9516 |
| Practice Telephone | 4045455497 |
| Mailing Telephone | 4045455497 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SM0705X |
Clinical Nurse Specialist Specialization: Medical-Surgical |
APRN9630300 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
120 QUAIL HOLLOW DR |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-9516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 364SM0705X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Medical-Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265442057 | Jane S Old | Clinical Nurse Specialist | 2222 S 17th St, Wilmington, NC 28401-7515 | 2006-08-08 |
Please comment or provide details below to improve the information on STACEY MARIE BRUNDRETT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.