Provider Demographics
NPI:1437184595
Name:STAMEY, NANCY DIANE (MA)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:DIANE
Last Name:STAMEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HOSPITAL DR
Mailing Address - Street 2:SUITE 8
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8024
Mailing Address - Country:US
Mailing Address - Phone:828-452-1544
Mailing Address - Fax:828-452-1285
Practice Address - Street 1:600 HOSPITAL DR
Practice Address - Street 2:SUITE 8
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8024
Practice Address - Country:US
Practice Address - Phone:828-452-1544
Practice Address - Fax:828-452-1285
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC482174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105002Medicaid