MEDICARE: STACY L. FEE NP

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
1	363LF0000X	Family Nurse Practitioner	71006498A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000001044772	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1194271254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY L. FEE NP

Provider Business Mailing Address
First Line	:	1100 REID PKWY
Second Line	:	ATTN: MEDICAL STAFF SERVICES
City	:	RICHMOND
State	:	IN
Zip	:	47374-1157
Country	:	US
Telephone Number	:	765-983-3293
Fax Number	:	765-983-3219

Provider Business Practice Location Address
First Line	:	1501 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1914
Country	:	US
Telephone Number	:	765-935-1905
Fax Number	:	765-983-3219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2016
Last Update Date	:	05/13/2021

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Directions to “ STACY L. FEE NP” Practice Location

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