Stevenson, Lacey Ann

Stevenson, Lacey Ann is an individual health care provider with primary practice located at 615 S New Ballas Rd , Saint Louis MO 63141-8221. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Stevenson, Lacey Ann can be contacted via phone (314) 251-6090.

Contact Information

Primary practice address
615 S New Ballas Rd Saint Louis MO 63141-8221
Phone: (314) 251-6090
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 2018026933 Missouri

Profile Details

NPI number 1497319560
LBN Legal business name Stevenson, Lacey Ann
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2019
Last updated Jan 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497319560 NPPES
Missouri MEDICAID 420074828

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