Most Relevant Information
Provider Data
| NPI Number: | 1003656489 |
| Provider Name: | STACEY ANDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 163WL0100X |
| Specialty: | Registered Nurse |
| License Number: | L-311166 |
Most Important Dates
| Enumeration Date: | 05/31/2024 |
| Last Updated: | 05/31/2024 |
Provider Practice Location
114 MILL RD, GERMANTOWN, NY 12526, USA
GERMANTOWN
NY
12526
Practice Location Phone/Fax
| Phone: | 5189298822 |
| Fax: |
Provider Mailing Location
114 MILL RD
GERMANTOWN
NY
125265412
Provider Mailing Phone/Fax
| Phone: | 5189298822 |
| Fax: |