Healthcare Provider Details

I. General information

NPI: 1982842282
Provider Name (Legal Business Name): BELINDA L STANISLAUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 KILDAIRE FARM RD
CARY NC
27518-6616
US

IV. Provider business mailing address

1900 KILDAIRE FARM RD
CARY NC
27518-6616
US

V. Phone/Fax

Practice location:
  • Phone: 919-350-2300
  • Fax:
Mailing address:
  • Phone: 919-350-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number250545
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: