Provider Demographics
NPI:1538544598
Name:STANLEY, CATHY FRAZIER (RDMS)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:FRAZIER
Last Name:STANLEY
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 AVIEMORE CT
Mailing Address - Street 2:SUITE D
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9732
Mailing Address - Country:US
Mailing Address - Phone:910-690-6894
Mailing Address - Fax:
Practice Address - Street 1:80 AVIEMORE CT
Practice Address - Street 2:SUITE D
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9732
Practice Address - Country:US
Practice Address - Phone:910-690-6894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1078302471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography