Individual
EMILY STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(502) 627-7000
Mailing address
13929 FM 548, FORNEY, TX 75126-6407
(469) 552-1198
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300372
TX
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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