Individual
STACY LYNN SUMNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
489 TRAMMEL RD, CARRIER MILLS, IL 62917-1156
(618) 499-1405
Mailing address
489 TRAMMEL RD, CARRIER MILLS, IL 62917-1156
(618) 499-1405
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
174H000000
IL
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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