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Individual
STACEY HISER
Active
Individual
STACEY HISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1103814
KY
363LF0000X
Family Nurse Practitioner
Primary
3005366
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000656939
ANTHEM BC & BS
—
01
—
1235323338
NPI
KY
05
—
7100116090
—
KY
Enumeration date
08/31/2007
Last updated
05/23/2024
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