STACY E SHIMP
Physician Assistant


Address: 1673 Ludwell Drive, Ambler, PA 19002

STACY E SHIMP (Credential# 743957) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2019. The license expiration date date is November 30, 2020. The license status is ACTIVE.

Business Overview

STACY E SHIMP is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002208. The credential type is physician assistant. The effective date is December 1, 2019. The expiration date is November 30, 2020. The business address is 1673 Ludwell Drive, Ambler, PA 19002. The current status is active.

Basic Information

Licensee Name STACY E SHIMP
Credential ID 743957
Credential Number 23.002208
Credential Type Physician Assistant
Business Address 1673 Ludwell Drive
Ambler
PA 19002
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2008-11-21
Effective Date 2019-12-01
Expiration Date 2020-11-30
Refresh Date 2019-11-26

Other licenses

ID Credential Code Credential Type Issue Term Status
520783 CSP.0044911 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2008-12-08 2015-03-01 - 2017-02-28 INACTIVE

Office Location

Street Address 1673 Ludwell Drive
City Ambler
State PA
Zip Code 19002

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Jeffrey Bourret 819 Foxfield Rd, Lower Gwynedd, PA 19002 Pharmacist 2018-08-27 ~ 2020-01-31
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Scott T Kupper 300 Brookside Ave., Ambler, PA 19002 Professional Engineer 2020-02-01 ~ 2021-01-31
Route Dynamics Corp. 200 Bolton Court, Ambler, PA 19002 Securities - Exemptions 2020-01-08 ~
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Competitor

Search similar business entities

City Ambler
Zip Code 19002
License Type Physician Assistant
License Type + County Physician Assistant + Ambler

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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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