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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265661490 NPPES
New York MEDICAID 03126056

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