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NPI Code Detail

MEDICARE: STACEY ELIZABETH GRAYBILL

MEDICARE: STACEY ELIZABETH GRAYBILL
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
11744R1103XResearch Study Abstracter/Coder

General Provider Information

NPI Number : 1770635013
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY ELIZABETH GRAYBILL
Provider Business Mailing Address
First Line : 628 W JOYNER AVE
Second Line :
City : RIDGECREST
State : CA
Zip : 93555-3108
Country : US
Telephone Number : 760-499-7419
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N NORMA ST
Second Line : SUITE 133
City : RIDGECREST
State : CA
Zip : 93555-2575
Country : US
Telephone Number : 760-499-7406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2007
Last Update Date : 07/08/2007

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Directions to “ STACEY ELIZABETH GRAYBILL ” Practice Location

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