MRS. STACI JEANNE SIDES


Address: 400 N Mount Zion Rd, Lebanon, IN 46052-9497
Phone: 7653350123

MRS. STACI JEANNE SIDES (NPI# 1023567823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023567823
Entity Type Individual
Full Name MRS. STACI JEANNE SIDES
Credential NP
Practice Address 400 N Mount Zion Rd
Lebanon
IN 46052-9497
Mailing Address 2705 N Lebanon St Ste 305
Lebanon
IN 46052-8622
Practice Telephone 7653350123
Practice Fax Number 7653350127
Enumeration Date 2016-09-22
Last Update Date 2020-05-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
71006609A IN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN 201403450 05

Office Location

Street Address 400 N MOUNT ZION RD
City LEBANON
State IN
Zip Code 46052-9497

Providers in the same location

NPI Name Taxonomy Address Enumeration
1942551684 Bhupinder K Gill Physical Therapist 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2012-09-20
1114576097 Angela Dawn Kirkendall Nurse Practitioner 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2019-09-04
1710535091 Stacy Marie Tavenner Nurse Practitioner 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2019-08-29
1427617810 Jessica Marie Bingham Nurse Practitioner 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2019-06-10
1255812129 Tara E Cwiak Physician Assistant 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2018-08-28
1174031843 Alexandria Joanne Roemke Nurse Practitioner 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2018-01-16
1053858621 Allison Rae Shrack Nurse Practitioner 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2017-01-20
1740638774 Abby Elizabeth White Nurse Practitioner 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2016-05-31
1417320870 Erica D Baker Nurse Practitioner 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2015-11-07
1144692864 Novapex Clinic/Center 400 N Mount Zion Rd, Lebanon, IN 46052-9497 2015-10-21
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316567647 Meredith England Labrie Behavioral Analyst 110 Birchwood Drivve, Lebanon, IN 46052 2020-04-16
1710401492 Kenzlie Ann Westerfield Specialist/Technologist 613 Countryside Drive, Lebanon, IN 46052 2017-08-03
1487040044 Jenny L Essex Social Worker 1614 N. Lebanon St., Integrative Wellness, LLC, Lebanon, IN 46052 2015-04-10
1316177363 Kathryn Elizabeth Ehrgott Counselor 1005 South Lebanon Street, Boone County Services, Lebanon, IN 46052 2009-07-23
1780838557 Kathleen M Whitaker Registered Nurse 209 W North St, Lebanon, IN 46052 2008-11-06
1851551998 James R Mcafee General Practice 1997 Terrace Ln, Lebanon, IN 46052 2008-06-12
1518021773 Zulfiqar Ali Mirza Internal Medicine 2505 N Lebanon St Ste 220, Lebanon, IN 46052 2006-12-21
1316016108 Russell Allen Lindner Chiropractor 3920 North State Road 39, Boone County Chiropractic Office, Lebanon, IN 46052 2006-11-07
1487755781 Cowan Drugs Inc Pharmacy 112 N Lebanon St, Lebanon, IN 46052 2006-09-26
1558463992 Cowan Drugs Inc Pharmacy 1639 N Lebanon St, Lebanon, IN 46052 2006-09-05
Find all providers in zip 46052

Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932525839 Lindsay Schommer Nurse Practitioner 1 Medical Center Dr - Neurology, Dartmouth-hitchcock Medical Center, Lebanon, NH 03756-0001 2014-03-16
1598016958 Kevin P Kalnoski Nurse Practitioner 864 Jay St, Lebanon, PA 17046-1924 2012-09-26
1891965927 Dana Michelle Logsdon Nurse Practitioner 727 W. Main St., Lebanon, KY 40033 2008-03-05
1184785826 Jane Shelby Pierce Nurse Practitioner 1432 W Main St, Suite 700, Lebanon, TN 37087-1323 2006-12-13
1932276466 Jennifer Ann Petty Nurse Practitioner 1123 North Castleheights Avenue, Suite H, Lebanon, TN 37087-1510 2006-11-29
1124645536 Christina Lynne Cohee Nurse Practitioner 2505 N Lebanon St Ste 220, Lebanon, IN 46052-8611 2020-07-01
1558987560 Kimberly Ruth Haller Nurse Practitioner 1 Medical Center Drive, Lebanon, NH 03756 2020-06-25
1477180552 Catherine Anton Nurse Practitioner 1 Medical Center Dr, Lebanon, NH 03756-1000 2020-03-26
1043772932 Connesuala Powers Nurse Practitioner 115 Winwood Dr Ste 205, Lebanon, TN 37087-1399 2019-04-01
1033692850 Alexa Ruppert Holleran Nurse Practitioner 10 Alice Peck Day Dr, Lebanon, NH 03766-2900 2018-09-07
Find all providers in LEBANON

Competitor

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City LEBANON
Zip Code 46052

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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