Grace, Stacy

Grace, Stacy is an individual health care provider with primary practice located at 120 White Horse Pike Suite 103, Haddon Heights NJ 08035-1938. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Grace, Stacy can be contacted via phone (856) 546-3900.

Contact Information

Primary practice address
120 White Horse Pike Suite 103 Haddon Heights NJ 08035-1938
Phone: (856) 546-3900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 26NO08583700 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 26NN08583700 New Jersey

Profile Details

NPI number 1043514805
LBN Legal business name Grace, Stacy
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 7th, 2011
Last updated Jan 18th, 2012 - about 13 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 1043514805 NPPES
New Jersey MEDICAID 8448604

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