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NPI Code Detail

MEDICARE: STACY GREENE

MEDICARE: STACY GREENE
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
1235Z00000XSpeech-Language Pathologist3175KY

General Provider Information

NPI Number : 1003938085
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY GREENE
Provider Business Mailing Address
First Line : 142 LACKAWANNA RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-1914
Country : US
Telephone Number : 859-599-3019
Fax Number : 859-533-3019
Provider Business Practice Location Address
First Line : 436 HOUSTON OAKS DR
Second Line :
City : PARIS
State : KY
Zip : 40361-2704
Country : US
Telephone Number : 606-584-1169
Fax Number : 606-763-6245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 04/20/2020

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Directions to “ STACY GREENE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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