Clancy, Kerry

Clancy, Kerry is an individual health care provider with primary practice located at 217 Glensford Dr , Fayetteville NC 28314. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Clancy, Kerry can be contacted via phone (910) 483-4647.

Contact Information

Primary practice address
217 Glensford Dr Fayetteville NC 28314
Phone: (910) 483-4647
Fax: (910) 483-6431
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 000102790 North Carolina

Profile Details

NPI number 1669473153
LBN Legal business name Clancy, Kerry
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Sep 10th, 2019 - about 6 years 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 1669473153 NPPES
North Carolina Other D7406 K. CLANCY'S MEDCOST #

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