MEDICARE: ALLISON DANIELLE STANCILL CRAY FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5010332	NC

General Provider Information

NPI Number	:	1396246286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON DANIELLE STANCILL CRAY FNP-C

Provider Business Mailing Address
First Line	:	642 WALSTON DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2683
Country	:	US
Telephone Number	:	910-231-8367
Fax Number	:

Provider Business Practice Location Address
First Line	:	6419 CAROLINA BEACH RD STE A
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-3672
Country	:	US
Telephone Number	:	910-790-3660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2018
Last Update Date	:	02/26/2018

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