Congdon, Stacy Lynn
Congdon, Stacy Lynn is an sole proprietor health care provider with primary practice located at 40 Arch St , Johnson City NY 13790-2102. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Congdon, Stacy Lynn can be contacted via phone (607) 763-6092.Contact Information
Primary practice address
40 Arch St
Johnson City NY 13790-2102
Phone: (607) 763-6092
Fax: (607) 763-6677
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 335984 | New York |
Profile Details
| NPI number | 1265661490 |
|---|---|
| LBN Legal business name | Congdon, Stacy Lynn |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 9th, 2009 |
| Last updated | Nov 23rd, 2009 - about 15 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 | 1265661490 | NPPES |
| New York | MEDICAID | 03126056 |
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