Brown, Stacy
Brown, Stacy is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Brown, Stacy can be contacted via phone (508) 334-6691.Contact Information
Primary practice address
55 Lake Ave N
Worcester MA 01655-0002
Phone: (508) 334-6691
Fax: (774) 441-7727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1818 | Massachusetts |
Profile Details
| NPI number | 1679548515 |
|---|---|
| LBN Legal business name | Brown, Stacy |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Jan 11th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679548515 | NPPES |
| Massachusetts | MEDICAID | 110125089A |
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