Eldridge, Stacy

Eldridge, Stacy is an individual health care provider with primary practice located at 2450 Tamiami Trl Ste A , Port Charlotte FL 33952-3922. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Eldridge, Stacy can be contacted via phone (941) 624-2704.

Contact Information

Primary practice address
2450 Tamiami Trl Ste A Port Charlotte FL 33952-3922
Phone: (941) 624-2704
Fax: (941) 627-6066
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71003974A Indiana
Nursing Service Providers / Registered Nurse 163W00000X 28137260A Indiana

Profile Details

NPI number 1265705743
LBN Legal business name Eldridge, Stacy
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2012
Last updated Sep 8th, 2021 - about 3 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 1265705743 NPPES
Indiana Other 000001037727 EMERGENCY MED PIN UNDER TIN 35-2030653
Indiana MEDICAID 201072520 EMERGENCY MED PIN UNDER TIN 35-2030653
Indiana Other 000000772667 EMERGENCY MED PIN UNDER TIN 35-2030653

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