Individual
MS. STACY ANN IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN532602
PA
363L00000X
Nurse Practitioner
SP008417
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN532602
PA
363LP0200X
Pediatric Nurse Practitioner
SP008417
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4071964
—
MD
05
—
61018
—
NJ
Enumeration date
11/02/2006
Last updated
08/30/2011
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