Provider Demographics
NPI:1235114323
Name:GEIL, STACY A (APRN)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:A
Last Name:GEIL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 CUMMINGS RD
Mailing Address - Street 2:STE W
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-2401
Mailing Address - Country:US
Mailing Address - Phone:620-276-1787
Mailing Address - Fax:620-275-9238
Practice Address - Street 1:2718 CUMMINGS RD
Practice Address - Street 2:STE W
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-2401
Practice Address - Country:US
Practice Address - Phone:620-276-1787
Practice Address - Fax:620-275-9238
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13 051247 061364S00000X
KS74038364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R49636Medicare UPIN
160994Medicare ID - Type UnspecifiedGROUP
161339Medicare ID - Type UnspecifiedINDIVIDUAL