STACEY E BACON NP-C
Individual Provider (NPI-1)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1003066085- Provider Type
- Individual Provider (NPI-1)
- Credentials
- NP-C
- Status
- Active
Contact & Location
- Address
- 1701 S BROADWAY ST, PITTSBURG, KS, 667625856
- Phone
- (620) 235-4452
Specialties & Taxonomies
Nurse Practitioner, Family
License: MO #2004015211
Nurse Practitioner, Family
Primary License: KS #75561