Healthcare Provider Details

I. General information

NPI: 1376919282
Provider Name (Legal Business Name): STACEY MORETZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N TERRACE PL
MORGANTON NC
28655-3759
US

IV. Provider business mailing address

600 N TERRACE PL
MORGANTON NC
28655-3759
US

V. Phone/Fax

Practice location:
  • Phone: 828-443-6303
  • Fax:
Mailing address:
  • Phone: 828-767-3248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5007903
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5007903
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: