Fulcher, Stacie Marie

Fulcher, Stacie Marie is an sole proprietor health care provider with primary practice located at 444 Nw Elks Drive , Corvallis OR 97330. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Fulcher, Stacie Marie can be contacted via phone (541) 754-1256.

Contact Information

Primary practice address
444 Nw Elks Drive Corvallis OR 97330
Phone: (541) 754-1256
Fax: (360) 597-1472
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1014 Nebraska
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA154004 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA154004 Oregon

Profile Details

NPI number 1013193556
LBN Legal business name Fulcher, Stacie Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 15th, 2008
Last updated Jun 20th, 2024 - about 2 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 1013193556 NPPES
Oregon MEDICAID 500642760

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