Stacey Marie Bast
NPI #1578105367 in Edwardsville, Illinois
Provider Information
- NPI Number
- 1578105367
- Entity Type
- Individual
- Name
- Stacey Marie Bast
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- Oct 13, 2019
- Last Updated
- Oct 13, 2019
Practice Location
- Address
- 223 GARDEN ST
- City
- Edwardsville
- State
- Illinois
- ZIP Code
- 62025-1974
- Phone
- (314) 420-9576
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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