Provider Demographics
NPI:1548787724
Name:MCADAMS, STACY E (LPN)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:E
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1418
Mailing Address - Country:US
Mailing Address - Phone:845-380-1688
Mailing Address - Fax:
Practice Address - Street 1:100 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-1418
Practice Address - Country:US
Practice Address - Phone:845-380-1688
Practice Address - Fax:845-380-1688
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229013-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse