Henry, Stacy
Henry, Stacy is an sole proprietor health care provider with primary practice located at 1210 W 18Th St Ste G01 , Sioux Falls SD 57104-4651. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Henry, Stacy can be contacted via phone (605) 328-2663.Contact Information
Primary practice address
1210 W 18Th St Ste G01
Sioux Falls SD 57104-4651
Phone: (605) 328-2663
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 111084 | Iowa |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X |
Profile Details
| NPI number | 1679141964 |
|---|---|
| LBN Legal business name | Henry, Stacy |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 14th, 2021 |
| Last updated | Dec 27th, 2023 - about 2 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 | 1679141964 | NPPES |
| Iowa | Other | 111804 | PA LICENSE |
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