Stacey Marie Bast, is a
Licensed Practical Nurse based in Edwardsville, Illinois. Stacey Marie Bast is licensed to practice in Illinois (license number 043-087181) and her current practice location is
223 Garden St, Edwardsville, Illinois. She can be reached at her office (for appointments etc.) via phone at
(314) 420-9576.
NPI number for Stacey Marie Bast is 1578105367 and her current mailing address is 153 Chester St, Chester, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1578105367.
Provider's Profile
Full Name | Stacey Marie Bast |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 223 Garden St, Edwardsville, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1578105367
- Provider Enumeration Date: 10/13/2019
- Last Update Date: 10/13/2019
Medical Identifiers
Medical identifiers for Stacey Marie Bast such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578105367 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 043-087181 (Illinois) | 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. Stacey Marie Bast 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 |
Stacey Marie Bast, 153 Chester St, Chester, IL 62233-1755 Ph: (618) 559-3482 | Stacey Marie Bast, 223 Garden St, Edwardsville, IL 62025-1974 Ph: (314) 420-9576 |
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