Hannan, Stacey Marie
Hannan, Stacey Marie is an sole proprietor health care provider with primary practice located at 2010 Village Center Dr Wal-Mart Vision Center, Tarentum PA 15084-3844. She recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Hannan, Stacey Marie can be contacted via phone (724) 274-0276.Contact Information
Primary practice address
2010 Village Center Dr Wal-Mart Vision Center
Tarentum PA 15084-3844
Phone: (724) 274-0276
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OEG001285 | Pennsylvania |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OEG001285 | Pennsylvania |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | OEG001285 | Pennsylvania |
Profile Details
| NPI number | 1699711747 |
|---|---|
| LBN Legal business name | Hannan, Stacey Marie |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Dec 20th, 2007 - about 19 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 | 1699711747 | NPPES |
| Pennsylvania | Other | 1594678 | HIGHMARK BC/BS |
| Pennsylvania | MEDICAID | 1009498450001 | HIGHMARK BC/BS |
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