Provider Demographics
NPI:1124693734
Name:SILKEY, STORMY (HIS)
Entity type:Individual
Prefix:
First Name:STORMY
Middle Name:
Last Name:SILKEY
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3473 RIDER TRL S
Mailing Address - Street 2:
Mailing Address - City:EARTH CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63045-1110
Mailing Address - Country:US
Mailing Address - Phone:314-328-0088
Mailing Address - Fax:
Practice Address - Street 1:2001 HWY 248 STE 5
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-4513
Practice Address - Country:US
Practice Address - Phone:417-334-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015012048237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist