Dement, Stacie E
Dement, Stacie E is an individual health care provider with primary practice located at 13400 E Shea Blvd , Scottsdale AZ 85259-5404. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Dement, Stacie E can be contacted via phone (480) 301-8000.Contact Information
Primary practice address
13400 E Shea Blvd
Scottsdale AZ 85259-5404
Phone: (480) 301-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 2117 | Arizona |
Profile Details
| NPI number | 1972585396 |
|---|---|
| LBN Legal business name | Dement, Stacie E |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2005 |
| Last updated | Oct 29th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972585396 | NPPES |
| Arizona | Other | 86080015085259C045 | TRIWEST |
| Arizona | MEDICAID | 438558 | TRIWEST |
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