MARY JAEGER STACY FNP NPI 1790741072

NPI Information

NPI: 1790741072
Provider Name: MARY JAEGER STACY, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
5957 MAIN ST
NORTHSHIRE MEDICAL CENTER
MANCHESTER CENTER, VT
ZIP 05255
Phone: (802) 362-4440
Get Directions

Mary Jaeger Stacy, FNP is a family nurse practitioner in Manchester Center, VT. Mary Jaeger Stacy, FNP NPI is 1790741072. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5957 MAIN ST
NORTHSHIRE MEDICAL CENTER
MANCHESTER CENTER, VT
ZIP 05255-913
Phone: (802) 362-4440
Fax: (802) 362-7146

The enumeration date for this NPI number is 4/25/2006 and was last updated on 1/13/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	101-0019775	VERMONT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0NP1782	MEDICAID	VERMONT
2	NP178203	MEDICARE PIN	VERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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