Provider Demographics
NPI:1851635239
Name:DENLINGER, STACEY S (DO)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:S
Last Name:DENLINGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:S
Other - Last Name:STUTZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:930 RED ROSE CT STE 104
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1981
Mailing Address - Country:US
Mailing Address - Phone:717-987-1983
Mailing Address - Fax:717-614-1000
Practice Address - Street 1:930 RED ROSE CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1981
Practice Address - Country:US
Practice Address - Phone:717-987-1983
Practice Address - Fax:717-614-1000
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-25
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014114207Q00000X
PAOS017180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101957171Medicaid