Provider Demographics
NPI:1255564357
Name:HOWELL, STACEY D (APRN)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:D
Last Name:HOWELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:D
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 47490
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-7490
Mailing Address - Country:US
Mailing Address - Phone:316-962-3150
Mailing Address - Fax:316-962-7334
Practice Address - Street 1:550 N. HILLSIDE
Practice Address - Street 2:KU WICHITA PEDIATRIC HOSPITALISTS
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214
Practice Address - Country:US
Practice Address - Phone:316-962-2269
Practice Address - Fax:316-962-7805
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75045363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics