NPI 1487231395

Stacy Marie Gantz

Practitioner Student in an Organized Health Care Education/Training Program Waldorf, MD

Practice location

Address: 3 Post Office Rd STE 105, Waldorf, MD 20602-2756
Phone: (301) 893-2345
Mailing address: 2944 Gracefield Rd, Silver Spring, MD 20904-1667

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1487231395
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Mar 2021
Record last updated: 26 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.