Provider Demographics
NPI:1376041673
Name:FLANARY, STACIE RANAE (LPN)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:RANAE
Last Name:FLANARY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:STACIE
Other - Middle Name:RANAE
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:5420 OXFORD MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1915
Mailing Address - Country:US
Mailing Address - Phone:513-544-4869
Mailing Address - Fax:
Practice Address - Street 1:5420 OXFORD MILFORD RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1915
Practice Address - Country:US
Practice Address - Phone:513-544-4869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH109793164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse