Stacy, Evelyn M

Stacy, Evelyn M is an individual health care provider with primary practice located at 100 Hitchcock Way , Manchester NH 03104-4125. She recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Adolescent, Nursing Service Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Adolescent is her primary health care specialty. Stacy, Evelyn M can be contacted via phone (603) 695-2500.

Contact Information

Primary practice address
100 Hitchcock Way Manchester NH 03104-4125
Phone: (603) 695-2500
Fax: (603) 898-4779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Adolescent 364SP0807X 029942-23 New Hampshire
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X RN 02994221 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 029942-23 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AR NP 0299422308 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AR NP 0299422302 New Hampshire

Profile Details

NPI number 1740233030
LBN Legal business name Stacy, Evelyn M
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Feb 24th, 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 1740233030 NPPES
New Hampshire MEDICAID 30009223

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