DERICA STAKE LPN NPI 1770242570

NPI Information

  • NPI: 1770242570
  • Provider Name: DERICA STAKE, LPN
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 120 BULL STRING LN
    GREENUP, KY
    ZIP 41144
  • Phone: (606) 922-8207

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NPI Details

Derica Stake, LPN is a licensed practical nurse in Greenup, KY. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Derica Stake, LPN NPI is 1770242570. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

120 BULL STRING LN
GREENUP, KY
ZIP 41144-175
Phone: (606) 922-8207

The enumeration date for this NPI number is 12/9/2021 and was last updated on 12/9/2021.

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
1164W00000XLicensed Practical Nurse156627OHIOYes

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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