Alicia Marie Stout
Individual provider Active NPI Licensed Practical Nurse · Canastota, NY
NPI 1124437629 · NPPES record last updated Aug 8, 2014
Key facts
- NPI
- 1124437629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 319236 (NY)
- Practice address
- 432 New Boston St
3
Canastota, NY 13032-1046 - Phone
- (315) 632-5097
- NPI assigned
- Aug 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 319236 | NY | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 319236 | NY | Yes |
Addresses
Primary practice location
432 New Boston St
3
Canastota, NY 13032-1046
Mailing address
432 New Boston St
3
Canastota, NY 13032-1046
Phone (315) 632-5097
Other names
- Alicia Precourt
Other providers in Canastota, NY
- Lauren Skibitski
- Sylvia Skinner-Defrancisco
- Andrea Pamadora Smyth
- Randolph Snow
- Anthony Michael Sorbello
- Maria Strong
- Kristin Mari Suchowiecki
- Tina Tannahill
- Sharle Ann Tassone
- Tracey Lynn Torrey
All providers in Canastota, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.