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STACY LYNN BOULTON
10000 FALLS OF NEUSE RD RALEIGH NC 276147839

STACY LYNN BOULTON is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1447216023. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 1456322643. The primary specialty is OBSTETRICS/GYNECOLOGY. The organization is WAKE SPECIALTY PHYSICIANS, LLC. The address is 10000 FALLS OF NEUSE RD, , RALEIGH, NC, 276147839. The zip code is 276147839.


Nation Provider ID1447216023
PAC ID by PECOS1456322643
Professional Enrollment IDI20121218000285
NameSTACY LYNN BOULTON
Medical School NameUNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE
Graduation Year2000
Primary SpecialtyOBSTETRICS/GYNECOLOGY
All secondary specialties
Organization NameWAKE SPECIALTY PHYSICIANS, LLC
Group Practice PAC ID7416006085
Number of Group Practice members127
Address10000 FALLS OF NEUSE RD, , RALEIGH, NC, 276147839
Hospital affiliation LBN
Graduation Year2000
Contact Number
Email Address[Show_Email_ID]

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