Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STACEY MARIE BAST
Active Sole ProprietorSTACEY MARIE BAST is a Licensed Practical Nurse healthcare provider located in EDWARDSVILLE, Illinois. NPI 1578105367 is currently active in the NPPES registry. Verify at CMS.
Licensed Practical Nurse · EDWARDSVILLE, IL
Registration Details
- NPI Number
- 1578105367
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 13, 2019 (6.850473787028 yrs)
- Last Updated
- Oct 13, 2019
- License
-
043-087181 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
223 GARDEN STEDWARDSVILLE, IL, 620251974Browse IL providers · Browse ZIP 62025
- Phone
- 3144209576
- Primary Specialty
-
Licensed Practical Nurse
164W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.