Individual provider · Type 1 NPI

Stacy Annette Church, PA-C

Medical Physician Assistant · Charleston, WV

NPI number 1114930658 Active

Practice location

3100 Maccorkle Ave SE, Suite 610
Charleston, WV 25304-1223

Call (304) 346-1141 Map

Fax (304) 346-1142

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X01163 (WV)

Medical Physician Assistant: Definition to come...

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About NPI 1114930658

Stacy Annette Church, PA-C's National Provider Identifier is 1114930658, issued on Aug 15, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Charleston, WV. The record was last updated on Jun 21, 2011.