Healthcare Provider Details

I. General information

NPI: 1235514290
Provider Name (Legal Business Name): STACI NICOLE LEMASTERS M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W WILLIAMS ST STE 271
APEX NC
27502-5204
US

IV. Provider business mailing address

800 W WILLIAMS ST STE 271
APEX NC
27502-5204
US

V. Phone/Fax

Practice location:
  • Phone: 919-610-9298
  • Fax: 919-439-6380
Mailing address:
  • Phone: 919-610-9298
  • Fax: 919-439-6380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1603087
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: