Davenport, Stacy
Davenport, Stacy is an individual health care provider with primary practice located at 630 Addison Ave W Ste 1000 , Twin Falls ID 83301-5853. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Davenport, Stacy can be contacted via phone (208) 736-5048.Contact Information
Primary practice address
630 Addison Ave W Ste 1000
Twin Falls ID 83301-5853
Phone: (208) 736-5048
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1780399394 |
|---|---|
| LBN Legal business name | Davenport, Stacy |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2023 |
| Last updated | Jan 18th, 2023 - about 2 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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