Kucharczk, Stacy

Kucharczk, Stacy is an individual health care provider with primary practice located at 1735 City Center Blvd , Elizabeth City NC 27909-8960. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Kucharczk, Stacy can be contacted via phone (252) 338-2155.

Contact Information

Primary practice address
1735 City Center Blvd Elizabeth City NC 27909-8960
Fax: (252) 338-7704
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 5004933 North Carolina

Profile Details

NPI number 1912924663
LBN Legal business name Kucharczk, Stacy
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Dec 11th, 2012 - about 12 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 1912924663 NPPES
Virginia Other 28859N OPTIMA, OFC,FAMIS
Virginia MEDICAID 7787758 OPTIMA, OFC,FAMIS
Virginia Other 541778786 OPTIMA, OFC,FAMIS

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