Brown, Stacy
Brown, Stacy is an individual health care provider with primary practice located at 901 18Th St E , Tifton GA 31794-3648. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Occupational Health, which is considered as her primary health care specialty. Brown, Stacy can be contacted via phone (229) 353-6124.Contact Information
Primary practice address
901 18Th St E
Tifton GA 31794-3648
Phone: (229) 353-6124
Fax: (229) 353-7722
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Occupational Health | 364SX0106X | OTA001175 | Georgia |
Profile Details
| NPI number | 1952723603 |
|---|---|
| LBN Legal business name | Brown, Stacy |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2014 |
| Last updated | Jan 15th, 2014 - about 10 years ago |
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 | 1952723603 | NPPES |
| Georgia | Other | OTA001175 | LICENSE NUMBER |
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