Provider Demographics
NPI:1568437374
Name:HOSTETTER, STACY E (NP)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:E
Last Name:HOSTETTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:E
Other - Last Name:HUTCHENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 TER HEUN DRIVE
Mailing Address - Street 2:FALMOUTH HOSPITAL
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540
Mailing Address - Country:US
Mailing Address - Phone:508-457-3748
Mailing Address - Fax:508-457-3749
Practice Address - Street 1:100 TER HEUN DRIVE
Practice Address - Street 2:FALMOUTH HOSPITAL HOSPITALIST DEPARTMENT
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-457-3748
Practice Address - Fax:508-457-3749
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP5183OtherBCBS
MANP5183OtherBCBS
Q56417Medicare UPIN