Mr Shawn Henry Stacy, LPN | |
1213 Fudge Dr, Beavercreek, OH 45434-6720 | |
(937) 431-8861 | |
Not Available |
Full Name | Mr Shawn Henry Stacy |
---|---|
Gender | Male |
Speciality | Licensed Practical Nurse |
Location | 1213 Fudge Dr, Beavercreek, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568784627 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
164W00000X | Licensed Practical Nurse | PN. 131419 (Ohio) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr Shawn Henry Stacy, LPN 1213 Fudge Dr, Beavercreek, OH 45434-6720 Ph: (937) 431-8861 | Mr Shawn Henry Stacy, LPN 1213 Fudge Dr, Beavercreek, OH 45434-6720 Ph: (937) 431-8861 |
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