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General NPI Number Information
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NPI Number | 1366577132
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Entity Type | Individual
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Provider Name | STACY A. LOURIE NP
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 239 CHRISTIANA RD.
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City | NEW CASTLE
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State | DE
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Zip | 19720-0000
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Country | US
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Telephone | 302-322-0860
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Fax | 302-322-4494
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Provider Business Mailing Address
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Address Line | 305 BEAVER CT
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City | MULLICA HILL
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State | NJ
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Zip | 08062-2804
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Country | US
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Telephone | 856-223-8872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | L1-0038026
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0000500
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NN08027300
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License Number State | NJ
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