Provider Demographics
NPI:1407281348
Name:SCOTT, STACY LEE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 PARK LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-9454
Mailing Address - Country:US
Mailing Address - Phone:919-200-8327
Mailing Address - Fax:
Practice Address - Street 1:UNC FAMILY MEDICINE 590 MANNING DR CLB # 7595
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6374
Practice Address - Country:US
Practice Address - Phone:984-974-0210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1407281348Medicaid