Keller, Stacey Lynn

Keller, Stacey Lynn is an individual health care provider with primary practice located at 7072 Mears Gate Dr Nw , North Canton OH 44720-8850. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Keller, Stacey Lynn can be contacted via phone (330) 966-1319.

Contact Information

Primary practice address
7072 Mears Gate Dr Nw North Canton OH 44720-8850
Phone: (330) 966-1319
Fax: (330) 966-1321
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50-003643 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 50003643 Ohio

Profile Details

NPI number 1831441831
LBN Legal business name Keller, Stacey Lynn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2012
Last updated Mar 14th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831441831 NPPES
Ohio MEDICAID 0086155

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