Provider Demographics
NPI:1710759006
Name:VARVEL, STACY
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:VARVEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6014
Mailing Address - Country:US
Mailing Address - Phone:843-871-9622
Mailing Address - Fax:
Practice Address - Street 1:140 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6014
Practice Address - Country:US
Practice Address - Phone:843-871-9622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker