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NPI Code Detail

MEDICARE: STACY KIRBY PMHNP-BC

MEDICARE: STACY KIRBY PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner3015980KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861070989
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY KIRBY PMHNP-BC
Provider Business Mailing Address
First Line : 832 HIGHWAY 15 N
Second Line :
City : JACKSON
State : KY
Zip : 41339-8284
Country : US
Telephone Number : 606-666-5142
Fax Number : 606-666-4172
Provider Business Practice Location Address
First Line : 832 HIGHWAY 15 N
Second Line :
City : JACKSON
State : KY
Zip : 41339-8284
Country : US
Telephone Number : 606-666-5142
Fax Number : 606-666-4172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2021
Last Update Date : 05/09/2023

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Directions to “ STACY KIRBY PMHNP-BC” Practice Location

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