Individual
MS. STACY JERVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, MED, CNRN
Contact information
Practice address
2508 EDGEMONT DR STE 2, ARKANSAS CITY, KS 67005-3844
(620) 442-7120
Mailing address
2508 EDGEMONT DR STE 2, ARKANSAS CITY, KS 67005-3844
(620) 442-7120
(620) 442-7121
Taxonomy
Speciality
Code
Description
License number
State
163WN0800X
Neuroscience Registered Nurse
14-127265-032
KS
363LF0000X
Family Nurse Practitioner
Primary
53-76375-032
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
KA5478001
—
KS
Enumeration date
09/01/2014
Last updated
02/07/2022
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