Vanderver, Stacie Dawn
Vanderver, Stacie Dawn is an individual health care provider with primary practice located at 2850 S Industrial Hwy Spc 5758 , Ann Arbor MI 48104-6796. She recently has only one registered license in Nursing Service Providers / Pediatrics, which is considered as her primary health care specialty. Vanderver, Stacie Dawn can be contacted via phone (734) 477-7298.Contact Information
Primary practice address
2850 S Industrial Hwy Spc 5758
Ann Arbor MI 48104-6796
Phone: (734) 477-7298
Fax: (734) 998-2369
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Pediatrics | 163WP0200X | 4704254099 | Michigan |
Profile Details
| NPI number | 1790019222 |
|---|---|
| LBN Legal business name | Vanderver, Stacie Dawn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2009 |
| Last updated | Sep 30th, 2009 - about 17 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 | 1790019222 | NPPES |
| Michigan | MEDICAID | 46848699 |
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