Harris, Staci Sithembile
Harris, Staci Sithembile is an individual health care provider with primary practice located at 2550 S 41St St , Wilmington NC 28403-5519. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Harris, Staci Sithembile can be contacted via phone (704) 695-1421.Contact Information
Primary practice address
2550 S 41St St
Wilmington NC 28403-5519
Phone: (704) 695-1421
Fax: (704) 694-7748
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 5009104 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 20490 | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 5009104 | North Carolina |
Profile Details
| NPI number | 1134679012 |
|---|---|
| LBN Legal business name | Harris, Staci Sithembile |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2016 |
| Last updated | Feb 22nd, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134679012 | NPPES |
| North Carolina | MEDICAID | 0000000 |
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