Royce, Stacey Bispham
Royce, Stacey Bispham is an individual health care provider with primary practice located at 6001 21St Ave W , Bradenton FL 34209-7847. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Royce, Stacey Bispham can be contacted via phone (941) 761-4448.Contact Information
Primary practice address
6001 21St Ave W
Bradenton FL 34209-7847
Phone: (941) 761-4448
Fax: (941) 761-0235
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9104208 | Florida |
Profile Details
| NPI number | 1205027620 |
|---|---|
| LBN Legal business name | Royce, Stacey Bispham |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2007 |
| Last updated | Sep 10th, 2019 - about 7 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 | 1205027620 | NPPES |
| Florida | Other | PA9104208 | STATE LICENSE NUMBER |
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