Provider Demographics
NPI:1134751431
Name:LAWHON, STACY LEE
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:LEE
Last Name:LAWHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 PETES WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9659
Mailing Address - Country:US
Mailing Address - Phone:775-375-8170
Mailing Address - Fax:
Practice Address - Street 1:985 PETES WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-9659
Practice Address - Country:US
Practice Address - Phone:775-375-8170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide