Stacey, Amy

Stacey, Amy is an individual health care provider with primary practice located at 502 W Saint Louis St Ste 4 , West Frankfort IL 62896-1968. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Stacey, Amy can be contacted via phone (618) 937-3400.

Contact Information

Primary practice address
502 W Saint Louis St Ste 4 West Frankfort IL 62896-1968
Phone: (618) 937-3400
Fax: (618) 997-9324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085007306 Illinois

Profile Details

NPI number 1962041830
LBN Legal business name Stacey, Amy
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 24th, 2019
Last updated Dec 24th, 2019 - about 6 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 1962041830 NPPES
Illinois Other 214881 MULTI SPECIALTY GROUP PTAN

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