STACY GARDNER NPI 1285806422

NPI Information

  • NPI: 1285806422
  • Provider Name: STACY GARDNER
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: PROFESSIONAL HEALTH SERVICES
  • Address: 410 W SAINT LOUIS ST
    WEST FRANKFORT, IL
    ZIP 62896
  • Phone: (618) 932-2200

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NPI Details

STACY GARDNER is a family nurse practitioner in West Frankfort, IL. STACY GARDNER NPI is 1285806422. The provider is registered as an organization entity type.
The provider Is Doing Business As Professional Health Services.

The provider's business location address is:

410 W SAINT LOUIS ST
WEST FRANKFORT, IL
ZIP 62896-956
Phone: (618) 932-2200
Fax: (618) 932-2202

The provider's authorized official is Stacy Gardner .
The authorized official title is Family Nurse Practitioner/ Owner and has the following contact phone number (618) 932-2200.

The enumeration date for this NPI number is 3/27/2008 and was last updated on 8/17/2009.

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
1261QR1300XClinic/CenterRural Health209007026ILLINOISNo
2363LF0000XNurse PractitionerFamilyYes

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: 11/21/2025

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