Dicke, Stacey M.

Dicke, Stacey M. is an sole proprietor health care provider with primary practice located at 30 Delaware Ave , Cortland NY 13045-3335. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Dicke, Stacey M. can be contacted via phone (607) 753-0513.

Contact Information

Primary practice address
30 Delaware Ave Cortland NY 13045-3335
Phone: (607) 753-0513
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 248239 New York

Profile Details

NPI number 1063541803
LBN Legal business name Dicke, Stacey M.
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 5th, 2007
Last updated Jul 9th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063541803 NPPES
New York MEDICAID 02113399

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