Graven, Stacey Ann

Graven, Stacey Ann is an individual health care provider with primary practice located at 800 N 1St St , Springfield IL 62702-3719. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Graven, Stacey Ann can be contacted via phone (217) 528-7541.

Contact Information

Primary practice address
800 N 1St St Springfield IL 62702-3719
Phone: (217) 528-7541
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 209007192 Illinois

Profile Details

NPI number 1881840791
LBN Legal business name Graven, Stacey Ann
Credentials ACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2008
Last updated May 22nd, 2020 - about 4 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 1881840791 NPPES
Illinois Other R03746 MEDICARE PTAN

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