Individual
STACY L JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
557 MAIN ST, LOGAN, WV 25601-3809
(304) 752-3435
Mailing address
PO BOX 390, HUNTINGTON, WV 25708-0390
(304) 429-1088
(304) 696-1623
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
62349
WV
363LF0000X
Family Nurse Practitioner
Primary
62349
WV
Other
Enumeration date
11/09/2010
Last updated
01/17/2018
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