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NPI Code Detail

MEDICARE: MRS. STACY L FORST PA-C

MEDICARE: MRS. STACY L FORST PA-C
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
1363AM0700XMedical Physician AssistantWV1617WV
2363A00000XPhysician Assistant10000517AIN

General Provider Information

NPI Number : 1649272410
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STACY L FORST PA-C
Provider Business Mailing Address
First Line : 2 FALLING WATER LN
Second Line :
City : MORGANTOWN
State : WV
Zip : 26508-4498
Country : US
Telephone Number : 260-417-1245
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26506-1200
Country : US
Telephone Number : 304-598-6984
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 01/25/2023

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Directions to “ MRS. STACY L FORST PA-C” Practice Location

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