Individual
MS. STACEY ANNE BULFINCH IDICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
216 EDGEFIELD AVE NW, AIKEN, SC 29801-3910
(803) 648-4224
(803) 641-7600
Mailing address
216 EDGEFIELD AVE NW, AIKEN, SC 29801-3910
(803) 648-4224
(803) 641-7600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18150
SC
Other
Enumeration date
03/29/2013
Last updated
04/30/2019
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