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Individual
KERRY CLANCY
Active
Individual
KERRY CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000102790
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D7406
K. CLANCY'S MEDCOST #
NC
Enumeration date
08/09/2005
Last updated
09/10/2019
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