Stacy, Joan E

Stacy, Joan E is an individual health care provider with primary practice located at 1108 Lavaca St Ste 110-320 , Austin TX 78701-2172. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Stacy, Joan E can be contacted via phone (512) 477-4088.

Contact Information

Primary practice address
1108 Lavaca St Ste 110-320 Austin TX 78701-2172
Phone: (512) 477-4088
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 5006812 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP138688 Texas

Profile Details

NPI number 1558789487
LBN Legal business name Stacy, Joan E
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2014
Last updated Jun 12th, 2023 - about 3 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 1558789487 NPPES
South Carolina MEDICAID NP2777
South Carolina MEDICAID 1558789487

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