Jervis, Stacy

Jervis, Stacy is an individual health care provider with primary practice located at 2508 Edgemont Dr Ste 2 , Arkansas City KS 67005-3844. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Neuroscience, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Jervis, Stacy can be contacted via phone (620) 442-7120.

Contact Information

Primary practice address
2508 Edgemont Dr Ste 2 Arkansas City KS 67005-3844
Phone: (620) 442-7120
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Neuroscience 163WN0800X 14-127265-032 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 53-76375-032 Kansas

Profile Details

NPI number 1538569199
LBN Legal business name Jervis, Stacy
Credentials FNP-BC, MED, CNRN
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2014
Last updated Feb 7th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538569199 NPPES
Kansas MEDICAID KA5478001

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