Stacy Durfee

Individual provider Active NPI Contractor · Virginia Beach, VA

NPI 1154735868 · NPPES record last updated Jun 20, 2014

Key facts

NPI
1154735868
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
117 S First Colonial Rd
Virginia Beach, VA 23454-4656
Phone
(757) 422-0409
Fax
(757) 422-2124
NPI assigned
Jun 20, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

117 S First Colonial Rd
Virginia Beach, VA 23454-4656

Mailing address

PO Box 8786
Virginia Beach, VA 23450-8786
Phone (757) 422-0409

Other identifiers

IdentifierTypeStateIssuer
465276261OtherVAFEIN

Other providers in Virginia Beach, VA

All providers in Virginia Beach, VA · Contractor in Virginia

Sources for this page

Verify at the official NPI Registry.