Provider Demographics
NPI:1386697282
Name:FILION, STACY LYNN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LYNN
Last Name:FILION
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:LYNN
Other - Last Name:FUDALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:505 W HOLLIS ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1358
Mailing Address - Country:US
Mailing Address - Phone:603-579-9648
Mailing Address - Fax:603-579-9647
Practice Address - Street 1:505 W HOLLIS ST
Practice Address - Street 2:SUITE 111
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1358
Practice Address - Country:US
Practice Address - Phone:603-579-9648
Practice Address - Fax:603-579-9647
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHP96926Medicare UPIN