Individual
MRS. JACEY DIAN STANCIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
131 SILVERWOOD CT STE 100, RINCON, GA 31326-5131
(912) 826-3927
(912) 826-3931
Mailing address
228 CLEARWATER CIR, PORT WENTWORTH, GA 31407-3311
(904) 437-8260
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
11643
GA
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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