Individual
STACY ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
832 HIGHWAY 15 N, JACKSON, KY 41339-8284
(606) 666-5142
(606) 666-4172
Mailing address
321C E COLLEGE AVE, STANTON, KY 40380-2325
(606) 663-9797
(606) 663-9470
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3015980
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100773010
—
KY
Enumeration date
03/30/2021
Last updated
04/06/2026
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