Clancy, Kerry
Clancy, Kerry is an individual health care provider with primary practice located at 217 Glensford Dr , Fayetteville NC 28314. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Clancy, Kerry can be contacted via phone (910) 483-4647.Contact Information
Primary practice address
217 Glensford Dr
Fayetteville NC 28314
Phone: (910) 483-4647
Fax: (910) 483-6431
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 000102790 | North Carolina |
Profile Details
| NPI number | 1669473153 |
|---|---|
| LBN Legal business name | Clancy, Kerry |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Sep 10th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669473153 | NPPES |
| North Carolina | Other | D7406 | K. CLANCY'S MEDCOST # |
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