Provider Demographics
NPI:1528683620
Name:FRIEND, STACIA LYNN (CNM)
Entity type:Individual
Prefix:
First Name:STACIA
Middle Name:LYNN
Last Name:FRIEND
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:STACIA
Other - Middle Name:LYNN
Other - Last Name:ALONGI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:1109 CHAPPELL CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-0069
Mailing Address - Country:US
Mailing Address - Phone:252-395-1445
Mailing Address - Fax:
Practice Address - Street 1:101 BETHESDA DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7201
Practice Address - Country:US
Practice Address - Phone:252-758-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife