Hannan, Stacey Marie

Hannan, Stacey Marie is an sole proprietor health care provider with primary practice located at 2010 Village Center Dr Wal-Mart Vision Center, Tarentum PA 15084-3844. She recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Hannan, Stacey Marie can be contacted via phone (724) 274-0276.

Contact Information

Primary practice address
2010 Village Center Dr Wal-Mart Vision Center Tarentum PA 15084-3844
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OEG001285 Pennsylvania
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X OEG001285 Pennsylvania
Eye and Vision Services Providers / Occupational Vision 152WX0102X OEG001285 Pennsylvania

Profile Details

NPI number 1699711747
LBN Legal business name Hannan, Stacey Marie
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 20th, 2006
Last updated Dec 20th, 2007 - about 17 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 1699711747 NPPES
Pennsylvania Other 1594678 HIGHMARK BC/BS
Pennsylvania MEDICAID 1009498450001 HIGHMARK BC/BS

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