Kirby, Stacy M

Kirby, Stacy M is an individual health care provider with primary practice located at 1815 - 1St Ave Se Suite 200, Cedar Rapids IA 52402-5417. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Kirby, Stacy M can be contacted via phone (319) 363-0474.

Contact Information

Primary practice address
1815 - 1St Ave Se Suite 200 Cedar Rapids IA 52402-5417
Phone: (319) 363-0474
Fax: (319) 363-2170
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 001929 Iowa

Profile Details

NPI number 1235393851
LBN Legal business name Kirby, Stacy M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2008
Last updated Aug 6th, 2013 - about 12 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 1235393851 NPPES
Iowa MEDICAID 1962610725

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