Devine, Stacey E

Devine, Stacey E is an individual health care provider with primary practice located at 19485 Old Jetton Rd Suite 100, Cornelius NC 28031-6582. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Devine, Stacey E can be contacted via phone (704) 384-1775.

Contact Information

Primary practice address
19485 Old Jetton Rd Suite 100 Cornelius NC 28031-6582
Fax: (704) 384-1776
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 200401383 North Carolina

Profile Details

NPI number 1912986852
LBN Legal business name Devine, Stacey E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Mar 18th, 2015 - about 9 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 1912986852 NPPES
North Carolina MEDICAID 5900010

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