Individual
CAROLE A STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2025 S WASHINGTON AVE, LANSING, MI 48910-0828
(888) 686-0749
Mailing address
10425 RIVER ROCK BLVD, DIMONDALE, MI 48821-8781
(517) 331-8668
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4704080504
MI
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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