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NPI Code Detail

MEDICARE: NICOLE CORT STUART PA-C

MEDICARE: NICOLE CORT STUART PA-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
1363A00000XPhysician Assistant0010-13990NC
2363AM0700XMedical Physician Assistant0010-13990NC

General Provider Information

NPI Number : 1487420808
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE CORT STUART PA-C
Provider Business Mailing Address
First Line : 3000 NEW BERN AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27610-1231
Country : US
Telephone Number : 786-368-4842
Fax Number :
Provider Business Practice Location Address
First Line : 3000 NEW BERN AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27610-1231
Country : US
Telephone Number : 919-350-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2023
Last Update Date : 01/22/2026

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Directions to “ NICOLE CORT STUART PA-C” Practice Location

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