Healthcare Provider Details

I. General information

NPI: 1659618791
Provider Name (Legal Business Name): STACI PESSETTI DUBOIS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACI MARIE PESSETTI PA-C

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 HEALTHPARK WAY STE 100
CLAYTON NC
27520-4497
US

IV. Provider business mailing address

5221 PARAMOUNT PKWY STE 220
MORRISVILLE NC
27560-5490
US

V. Phone/Fax

Practice location:
  • Phone: 919-585-8850
  • Fax: 919-585-8869
Mailing address:
  • Phone: 984-215-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number03966
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-03966
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: