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Individual
STACEY HUMPHREYS
Active
Individual
STACEY HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, CPNP
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
0001267140
VA
363LP0200X
Pediatric Nurse Practitioner
0024173915
VA
363LP0200X
Pediatric Nurse Practitioner
Primary
AC008959
MD
Other
Enumeration date
10/26/2006
Last updated
06/05/2026
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