Wright, Stacy R

Wright, Stacy R is an individual health care provider with primary practice located at 5 Good Samaritan Way , Mount Vernon IL 62864-2402. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wright, Stacy R can be contacted via phone (618) 899-1264.

Contact Information

Primary practice address
5 Good Samaritan Way Mount Vernon IL 62864-2402
Phone: (618) 899-1264
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209010682 Illinois

Profile Details

NPI number 1538593470
LBN Legal business name Wright, Stacy R
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2013
Last updated Oct 21st, 2020 - about 6 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 1538593470 NPPES
Illinois Other 209010682 STATE LICENSE

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