Provider Demographics
NPI:1184910937
Name:HUYNH, STAYCE LEA (FNP-C)
Entity type:Individual
Prefix:MS
First Name:STAYCE
Middle Name:LEA
Last Name:HUYNH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9456 BARTEL RD
Mailing Address - Street 2:
Mailing Address - City:BREWERTON
Mailing Address - State:NY
Mailing Address - Zip Code:13029-9649
Mailing Address - Country:US
Mailing Address - Phone:585-719-7757
Mailing Address - Fax:
Practice Address - Street 1:8003 BREWERTON RD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-9528
Practice Address - Country:US
Practice Address - Phone:315-288-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily