Provider Demographics
NPI:1669762902
Name:KREHER, STACEY MARIE (WHNP)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:MARIE
Last Name:KREHER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 BENIGNO LN.
Mailing Address - Street 2:HANCOCK WOMEN'S CENTER
Mailing Address - City:BAY ST. LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520
Mailing Address - Country:US
Mailing Address - Phone:228-467-2555
Mailing Address - Fax:228-467-5480
Practice Address - Street 1:1009 BENIGNO LN.
Practice Address - Street 2:HANCOCK WOMEN'S CENTER
Practice Address - City:BAY ST. LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520
Practice Address - Country:US
Practice Address - Phone:228-467-2555
Practice Address - Fax:228-467-5480
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR872268363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology