Provider Demographics
NPI:1083963359
Name:KEHL, STACY LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:LYNN
Last Name:KEHL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8406 PANAMA CITY BEACH PKWY STE K
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-4866
Mailing Address - Country:US
Mailing Address - Phone:850-990-3878
Mailing Address - Fax:
Practice Address - Street 1:8406 PANAMA CITY BEACH PKWY STE K
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-4866
Practice Address - Country:US
Practice Address - Phone:850-990-3878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-02
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3183012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily