Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
STACEY LAURINE EADIE
Active
Individual
STACEY LAURINE EADIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H0061035
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001285800
MEDICAL ASSISTANCE
MD
Enumeration date
03/03/2006
Last updated
11/05/2014
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