Stacy Shourt is a Pediatrics in Fayetteville, New York. Stacy Shourt practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Stacy Shourt is 1700061470. The last update date is 2020-03-06.
Stacy Shourt's current location address is 119 Brookside Ln, Fayetteville, New York. You can contact this provider via phone number 5625052040. The mailing address for Stacy Shourt is 119 Brookside Ln, Fayetteville, New York. To know further, please read the information below!
Provider Profile Detail
Provider Name | Stacy Shourt |
---|---|
Address | 119 Brookside Ln, Fayetteville, New York |
Phone Number | 5625052040 |
Fax Number | |
Sole Proprietor | N |
Credentials | PNP |
NPI Number Detail
NPI Number | 1700061470 |
---|---|
Provider Enumeration Date | 2007-12-31 |
Last Updated Date | 2020-03-06 |
Provider Mailing Address Detail
Address | 119 Brookside Ln |
---|---|
City | Fayetteville |
State | New York (NY) |
Post Code | 130661509 |
Phone Number | 5625052040 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Pediatrics |
---|---|
Taxonomy | 363Lp0200X |
Licence No | 16823 |
Definition: An advanced practice registered nurse expert in providing care to infants, children and adolescents. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
79032273 | CO | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Stacy Shourt by the Centers for Medicare & Medicaid Services?
The Stacy Shourt has been issued the NPI (National Provider Identifier) 1700061470. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Stacy Shourt's facilities are geographically located?
The facilities of Stacy Shourt are physically situated at the following location: 119 Brookside Ln, Fayetteville, NY, 130661509.
What is Stacy Shourt's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Stacy Shourt is Pediatrics, and the taxonomy code that classifies this field of practice is 363Lp0200X.
On what date did the Centers for Medicare & Medicaid Services issue the 1700061470 to Stacy Shourt?
The Stacy Shourt received its 1700061470 assignment from the Centers for Medicare & Medicaid Services on 2007-12-31.
As of what date were the details related to Stacy Shourt most recently updated or revised?
The information pertaining to Stacy Shourt, including its address, specialty, and other relevant details, was last updated or revised on 2020-03-06.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC
NPI Number: 1245233493
Address: 108 W Market St, Bloomington, IL