Provider Demographics
NPI:1316376528
Name:SILAS, STORMY (RN)
Entity Type:Individual
Prefix:MRS
First Name:STORMY
Middle Name:
Last Name:SILAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 W ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-2818
Mailing Address - Country:US
Mailing Address - Phone:704-296-6200
Mailing Address - Fax:704-296-6275
Practice Address - Street 1:1190 W ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-2818
Practice Address - Country:US
Practice Address - Phone:704-296-6200
Practice Address - Fax:704-296-6275
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC171471163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care