Roussell, Stacey Stokes

Roussell, Stacey Stokes is an individual health care provider with primary practice located at 439 Country Ln , Louisville KY 40207-1803. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Roussell, Stacey Stokes can be contacted via phone (502) 939-5378.

Contact Information

Primary practice address
439 Country Ln Louisville KY 40207-1803
Phone: (502) 939-5378
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 35005 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35005 Kentucky

Profile Details

NPI number 1770629099
LBN Legal business name Roussell, Stacey Stokes
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated May 8th, 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 1770629099 NPPES
Kentucky Other 000000200556 ANTHEM
Kentucky MEDICAID 64035678 ANTHEM
Kentucky Other 000000200556 ANTHEM
Kentucky Other 50035679 ANTHEM
Kentucky Other 000000739400 ANTHEM
Kentucky Other 129357 ANTHEM
Kentucky Other 611356201 ANTHEM

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