MR. Stacy Wayne Jefferson, LPN-IV
NPI #1861645574 in Georgetown, Ohio
Provider Information
- NPI Number
- 1861645574
- Entity Type
- Individual
- Name
- MR. Stacy Wayne Jefferson, LPN-IV
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Licensed Practical Nurse
- Credential
- LPN-IV
- Enumeration Date
- Oct 25, 2008
- Last Updated
- Oct 25, 2008
Practice Location
- Address
- 432 N GREEN ST
- City
- Georgetown
- State
- Ohio
- ZIP Code
- 45121-1011
- Phone
- (937) 213-0588
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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