Johnson, Stacy L

Johnson, Stacy L is an individual health care provider with primary practice located at 255 Spencer Rd Ste 201 , Saint Peters MO 63376-2576. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Johnson, Stacy L can be contacted via phone (636) 939-2550.

Contact Information

Primary practice address
255 Spencer Rd Ste 201 Saint Peters MO 63376-2576
Phone: (636) 939-2550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2018018396 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2020034563 Missouri

Profile Details

NPI number 1174002232
LBN Legal business name Johnson, Stacy L
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2018
Last updated Jul 22nd, 2024 - about 2 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 1174002232 NPPES
Missouri MEDICAID 420064105
Missouri Other 363LP0808X

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