Evans, Stacy L
Evans, Stacy L is an individual health care provider with primary practice located at 1351 Newtown Pike Bldg 1 , Lexington KY 40511-1277. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Evans, Stacy L can be contacted via phone (859) 253-1686.Contact Information
Primary practice address
1351 Newtown Pike Bldg 1
Lexington KY 40511-1277
Phone: (859) 253-1686
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X |
Profile Details
| NPI number | 1508410374 |
|---|---|
| LBN Legal business name | Evans, Stacy L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2019 |
| Last updated | Jul 30th, 2019 - about 6 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 | 1508410374 | NPPES |
| Kentucky | MEDICAID | 1790731081 |
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