Harris, Staci Sithembile

Harris, Staci Sithembile is an individual health care provider with primary practice located at 2550 S 41St St , Wilmington NC 28403-5519. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Harris, Staci Sithembile can be contacted via phone (704) 695-1421.

Contact Information

Primary practice address
2550 S 41St St Wilmington NC 28403-5519
Phone: (704) 695-1421
Fax: (704) 694-7748
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 5009104 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 20490 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 5009104 North Carolina

Profile Details

NPI number 1134679012
LBN Legal business name Harris, Staci Sithembile
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2016
Last updated Feb 22nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134679012 NPPES
North Carolina MEDICAID 0000000

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