Healthcare Provider Details

I. General information

NPI: 1720036395
Provider Name (Legal Business Name): STACEY ANN JOSLIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACEY ANN HEILE PA-C

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S ERIE ST STE E
MERCER PA
16137-1555
US

IV. Provider business mailing address

1034 GROVE ST
MEADVILLE PA
16335-2945
US

V. Phone/Fax

Practice location:
  • Phone: 724-662-4155
  • Fax: 724-662-2352
Mailing address:
  • Phone: 814-333-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA000217L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA001579L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: