Cameron Heath Stacy
Student in an Organized Health Care Education/Training Program in Louisville, KY. Individual provider (NPI-1).
NPI number1053054635
StatusActive
Last updated in NPPESApr 20, 2022
Details
- NPI
- 1053054635
- Entity type
- Individual (NPI-1)
- Name
- Cameron Heath Stacy
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 20, 2022
- Certification date
- Apr 20, 2022
- Last updated
- Apr 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
941 Charles StLouisville, KY 40204-2403
Phone 502-572-8839
Mailing address
941 Charles StLouisville, KY 40204-2403
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