Lynn, Stacie R
Lynn, Stacie R is an individual health care provider with primary practice located at 9863 Busleton Ave Ste A, Philadelphia PA 19115. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Lynn, Stacie R can be contacted via phone (215) 969-1100.Contact Information
Primary practice address
9863 Busleton Ave Ste A
Philadelphia PA 19115
Phone: (215) 969-1100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 046009376 | Illinois |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OEG002050 | Pennsylvania |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046-009376 | Illinois |
Profile Details
| NPI number | 1639164247 |
|---|---|
| LBN Legal business name | Lynn, Stacie R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Mar 19th, 2025 - about last year |
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 | 1639164247 | NPPES |
| Illinois | MEDICAID | 046009376 |
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