Nekic, Staci L.

Nekic, Staci L. is an individual health care provider with primary practice located at 211 N Eddy St , South Bend IN 46617-2808. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Nekic, Staci L. can be contacted via phone (574) 204-6650.

Contact Information

Primary practice address
211 N Eddy St South Bend IN 46617-2808
Phone: (574) 204-6650
Fax: (574) 204-6659
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 71005133 Indiana
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 28215108A Indiana

Profile Details

NPI number 1942560149
LBN Legal business name Nekic, Staci L.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2012
Last updated Jan 12th, 2016 - about 9 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 1942560149 NPPES
Indiana MEDICAID 201264510

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