Individual
STACY STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8 CENTURY PINES DR STE 2, BARRINGTON, NH 03825-3732
(603) 664-2135
(603) 664-9128
Mailing address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 664-2135
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1152
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3103418
—
NH
Enumeration date
02/08/2016
Last updated
08/02/2019
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