Holley, Stacy

Holley, Stacy is an individual health care provider with primary practice located at 107 E Main St , Grayson KY 41143-1301. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Holley, Stacy can be contacted via phone (606) 474-0244.

Contact Information

Primary practice address
107 E Main St Grayson KY 41143-1301
Phone: (606) 474-0244
Fax: (606) 474-0412
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 84657 West Virginia

Profile Details

NPI number 1144647652
LBN Legal business name Holley, Stacy
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2014
Last updated Sep 20th, 2023 - about 3 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 1144647652 NPPES
Ohio MEDICAID 0102228
Ohio Other 3053133
Ohio MEDICAID 7100295790

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