Henner Walden, Stacey
Henner Walden, Stacey is an individual health care provider with primary practice located at 57 Water St , Blue Hill ME 04614-5231. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Henner Walden, Stacey can be contacted via phone (207) 374-2311.Contact Information
Primary practice address
57 Water St
Blue Hill ME 04614-5231
Phone: (207) 374-2311
Fax: (207) 374-3991
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DO1879 | Maine |
Profile Details
| NPI number | 1548204183 |
|---|---|
| LBN Legal business name | Henner Walden, Stacey |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Jan 12th, 2021 - about 5 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 | 1548204183 | NPPES |
| Maine | MEDICAID | 1548204183 |
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