Wall, Stacey
Wall, Stacey is an individual health care provider with primary practice located at 13123 E 16Th Ave , Aurora CO 80045-7106. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Wall, Stacey can be contacted via phone (720) 777-1234.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 125686 | Colorado |
Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | 125686 | Colorado |
Profile Details
NPI number | 1770621930 |
---|---|
LBN Legal business name | Wall, Stacey |
Credentials | Pediatric Nurse Practitioner (PNP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 1st, 2007 |
Last updated | Jul 24th, 2020 - about 4 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1770621930 | NPPES |
Colorado | MEDICAID | 77455274 |
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