Cassidy, Staci Leigh

Cassidy, Staci Leigh is an individual health care provider with primary practice located at 1268 S 4Th St , Hartsville SC 29550-0703. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Cassidy, Staci Leigh can be contacted via phone (843) 332-3422.

Contact Information

Primary practice address
1268 S 4Th St Hartsville SC 29550-0703
Phone: (843) 332-3422
Fax: (843) 332-3985
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 24579 South Carolina

Profile Details

NPI number 1043892920
LBN Legal business name Cassidy, Staci Leigh
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2021
Last updated Mar 18th, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043892920 NPPES
Other SCL032 MEDICARE
MEDICAID NP7760 MEDICARE

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