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Individual
STACY LYNN GEMBERLING
Active
Individual
STACY LYNN GEMBERLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA054196
PA
363A00000X
Physician Assistant
Primary
OA002398
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031501300001
—
PA
Enumeration date
10/07/2009
Last updated
04/15/2022
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