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General NPI Number Information
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NPI Number | 1588322069
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Entity Type | Individual
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Provider Name | STACIE CHAFFIN WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 1000 DES PERES RD STE 300
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2040
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Country | US
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Telephone | 314-919-2600
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Fax | 314-919-2677
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Provider Business Mailing Address
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Address Line | PO BOX 776084
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City | CHICAGO
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State | IL
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Zip | 60677-6084
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Country | US
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Telephone | 314-919-2600
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Fax | 314-919-2677
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 209022260
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 2021023515
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License Number State | MO
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