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Individual
STACEY LEE FARMER
Active
Individual
STACEY LEE FARMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104661
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000232000
—
FL
01
—
PA9104661
MEDICAL LICENSE
FL
Enumeration date
10/28/2008
Last updated
07/21/2022
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