Mitchell, Stacey Lasandra
Mitchell, Stacey Lasandra is an sole proprietor health care provider with primary practice located at 1255 Highway 54 W , Fayetteville GA 30214-4526. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Mitchell, Stacey Lasandra can be contacted via phone (478) 464-8134.Contact Information
Primary practice address
1255 Highway 54 W
Fayetteville GA 30214-4526
Phone: (478) 464-8134
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 403153 | New York |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 203475 | Georgia |
Profile Details
| NPI number | 1245794387 |
|---|---|
| LBN Legal business name | Mitchell, Stacey Lasandra |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 23rd, 2019 |
| Last updated | Jul 26th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245794387 | NPPES |
| Georgia | Other | 1245794387 | NPI |
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