Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | SP011093 | PA |
NPI | 1003118019 |
---|---|
Provider Name | Stacy Schamp |
First Address | Mc Kees Rocks, PA 15136-1315 |
Second Address | Mc Kees Rocks, PA 15136-1315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2010 |
Last Update Date | 16/09/2019 |