Provider Demographics
NPI:1992162796
Name:RORIE, STACEY (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:
Last Name:RORIE
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 BLACK HORSE GAP RD
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:24064-1366
Mailing Address - Country:US
Mailing Address - Phone:605-553-2792
Mailing Address - Fax:
Practice Address - Street 1:1214 BLACK HORSE GAP RD
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:24064-1366
Practice Address - Country:US
Practice Address - Phone:605-553-2792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000020659363LF0000X
VA0024179192363L00000X, 363LF0000X
NDR43998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner