Provider Demographics
NPI:1275017204
Name:PLETCHER, STACI L (RN)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:L
Last Name:PLETCHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:STACI
Other - Middle Name:L
Other - Last Name:PABST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11255 WILKINSON RD
Mailing Address - Street 2:
Mailing Address - City:LENNON
Mailing Address - State:MI
Mailing Address - Zip Code:48449-9605
Mailing Address - Country:US
Mailing Address - Phone:989-413-5610
Mailing Address - Fax:
Practice Address - Street 1:1920 E KING ST
Practice Address - Street 2:
Practice Address - City:CORUNNA
Practice Address - State:MI
Practice Address - Zip Code:48817-1562
Practice Address - Country:US
Practice Address - Phone:989-413-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704254728163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health