Individual
STACEY VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 N AADEMY AVE, DANVILLE, PA 17822-2025
(570) 271-6621
(570) 271-6762
Mailing address
100 N AADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN626460
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209716
PROVIDER ID#
PA
Enumeration date
12/21/2015
Last updated
03/07/2016
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