Individual
STACY LANE MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3440 DECLARATION BLVD, SUMTER, SC 29154-8139
(803) 905-3278
(803) 905-3282
Mailing address
3440 DECLARATION BLVD, SUMTER, SC 29154-8139
(803) 905-3278
(803) 905-3282
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
4456
SC
363LF0000X
Family Nurse Practitioner
Primary
4456
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124180732
FASTER CARE NPI
SC
Enumeration date
02/07/2011
Last updated
03/22/2011
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