Provider Demographics
NPI:1992489082
Name:HOSEA, STACYE YVETTE (LPN)
Entity type:Individual
Prefix:MS
First Name:STACYE
Middle Name:YVETTE
Last Name:HOSEA
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 1:396 SPARROW RD
Mailing Address - Street 2:
Mailing Address - City:SWEET WATER
Mailing Address - State:AL
Mailing Address - Zip Code:36782-4307
Mailing Address - Country:US
Mailing Address - Phone:334-216-1597
Mailing Address - Fax:
Practice Address - Street 1:396 SPARROW RD
Practice Address - Street 2:
Practice Address - City:SWEET WATER
Practice Address - State:AL
Practice Address - Zip Code:36782-4307
Practice Address - Country:US
Practice Address - Phone:334-216-1597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2-040991164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse