Healthcare Provider Details

I. General information

NPI: 1710899737
Provider Name (Legal Business Name): STACY DEANN HOSMON CMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3299 STERNS RD
LAMBERTVILLE MI
48144-9807
US

IV. Provider business mailing address

8025 GEORGE ST
LAMBERTVILLE MI
48144-9639
US

V. Phone/Fax

Practice location:
  • Phone: 734-807-5152
  • Fax: 734-565-6680
Mailing address:
  • Phone: 618-727-9895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: