Stacy, Joan E
Stacy, Joan E is an individual health care provider with primary practice located at 1108 Lavaca St Ste 110-320 , Austin TX 78701-2172. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Stacy, Joan E can be contacted via phone (512) 477-4088.Contact Information
Primary practice address
1108 Lavaca St Ste 110-320
Austin TX 78701-2172
Phone: (512) 477-4088
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 5006812 | North Carolina |
Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | AP138688 | Texas |
Profile Details
NPI number | 1558789487 |
---|---|
LBN Legal business name | Stacy, Joan E |
Credentials | NP-C |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 28th, 2014 |
Last updated | Jun 12th, 2023 - about last year |
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 | 1558789487 | NPPES |
South Carolina | MEDICAID | NP2777 | |
South Carolina | MEDICAID | 1558789487 |
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