Provider Demographics
NPI:1518273556
Name:BASTIEN-SMITH, STACY L (BA, ALACE)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:L
Last Name:BASTIEN-SMITH
Suffix:
Gender:F
Credentials:BA, ALACE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 DENTON TAP RD
Mailing Address - Street 2:#1122
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8152
Mailing Address - Country:US
Mailing Address - Phone:940-206-9321
Mailing Address - Fax:
Practice Address - Street 1:2801 DENTON TAP RD
Practice Address - Street 2:#1122
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8152
Practice Address - Country:US
Practice Address - Phone:940-206-9321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula