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General NPI Number Information
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NPI Number | 1659233443
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Entity Type | Individual
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Provider Name | STACEY M LADD RN
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 7144 VILLAGE MEDICAL CIR
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City | CLEMMONS
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State | NC
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Zip | 27012-8004
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Country | US
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Telephone | 336-893-1437
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Fax | 336-893-1439
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Provider Business Mailing Address
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Address Line | 7144 VILLAGE MEDICAL CIR
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City | CLEMMONS
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State | NC
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Zip | 27012-8004
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Country | US
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Telephone | 336-893-1437
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Fax | 336-893-1439
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 164666
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License Number State | NC
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