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NPI Code Detail

MEDICARE: STACEY D'AQUILA

MEDICARE: STACEY D'AQUILA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251J00000XNursing Care Agency2001025320MO

General Provider Information

NPI Number : 1356686570
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY D'AQUILA
Provider Business Mailing Address
First Line : 1224 CLARKSON CT
Second Line :
City : ELLISVILLE
State : MO
Zip : 63011-2257
Country : US
Telephone Number : 314-616-5849
Fax Number :
Provider Business Practice Location Address
First Line : 850 COUNTRY MANOR LN
Second Line :
City : CREVE COEUR
State : MO
Zip : 63141-6651
Country : US
Telephone Number : 314-434-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2012
Last Update Date : 02/20/2019

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Directions to “ STACEY D'AQUILA ” Practice Location

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