Derica Stake, LPN is a
Licensed Practical Nurse based in Greenup, Kentucky. Derica Stake is licensed to practice in Ohio (license number 156627) and her current practice location is
120 Bull String Ln, Greenup, Kentucky. She can be reached at her office (for appointments etc.) via phone at
(606) 922-8207.
NPI number for Derica Stake is 1770242570 and her current mailing address is 120 Bull String Ln, Greenup, Kentucky. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1770242570.
Provider's Profile
| Full Name | Derica Stake |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Practical Nurse |
|---|
| Location | 120 Bull String Ln, Greenup, Kentucky |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1770242570
- Provider Enumeration Date: 12/09/2021
- Last Update Date: 12/09/2021
Medical Identifiers
Medical identifiers for Derica Stake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770242570 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 156627 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Derica Stake is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Derica Stake, LPN
120 Bull String Ln,
Greenup, KY 41144-6175
Ph: () - | Derica Stake, LPN
120 Bull String Ln,
Greenup, KY 41144-6175
Ph: (606) 922-8207 |
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