Individual
STACYE DICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
GNP-BC
Contact information
Practice address
14121 PARKE LONG CT, SUITE 200 & 201, CHANTILLY, VA 20151-1647
(571) 449-3585
(800) 752-2471
Mailing address
14121 PARKE LONG CT, SUITE 200 & 201, CHANTILLY, VA 20151-1647
(571) 449-3585
(800) 752-2471
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
256896
TX
Other
Enumeration date
10/04/2013
Last updated
10/04/2013
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