Provider Demographics
NPI:1053765917
Name:STARSMAN, STACEY ANN (CNM)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:ANN
Last Name:STARSMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:ANN
Other - Last Name:KELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4917 S CROATAN HWY
Mailing Address - Street 2:
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-8811
Mailing Address - Country:US
Mailing Address - Phone:252-449-2100
Mailing Address - Fax:252-449-2147
Practice Address - Street 1:4917 S CROATAN HWY
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-8811
Practice Address - Country:US
Practice Address - Phone:252-449-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC596367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife