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NPI Code Detail

MEDICARE: STACY JOAN SHIRK RN

MEDICARE: STACY JOAN SHIRK RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN325475LPA
2163WM0102XMaternal Newborn Registered NurseL-1-0049419DE

General Provider Information

NPI Number : 1578012530
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY JOAN SHIRK RN
Provider Business Mailing Address
First Line : PO BOX 167
Second Line :
City : LEWES
State : DE
Zip : 19958-0167
Country : US
Telephone Number : 717-226-9434
Fax Number :
Provider Business Practice Location Address
First Line : 424 SAVANNAH RD
Second Line :
City : LEWES
State : DE
Zip : 19958-1462
Country : US
Telephone Number : 302-645-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2016
Last Update Date : 09/30/2016

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