Stacey Outten Bachman, CRNP
Individual provider Active NPI Nurse Practitioner · Wilmington, DE
NPI 1790723674 · NPPES record last updated May 12, 2016
Key facts
- NPI
- 1790723674
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- LJ0000279 (DE)
- Practice address
- 1600 Rockland Rd
Wilmington, DE 19803-3607 - Phone
- (302) 651-4200
- NPI assigned
- Jun 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LJ0000279 | DE | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Past | Accepting new patients | |
| The Nemours Foundation | Past | Accepting new patients |
Interoperability endpoints
- sbachman39112@direct.nemours.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | LJ0000279 | DE | Yes |
Addresses
Primary practice location
1600 Rockland Rd
Wilmington, DE 19803-3607
Mailing address
PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-6212
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| UPOO5467D | Other | PA | CRNP LICENSE NUMBER |
Other providers in Wilmington, DE
- Brian Baar
- Evgeny Babak
- Nathan Joshua Babe
- Michele Lynn Babicki
- Janelle Bacani
- Steven J. Bachrach
- Shykera A Backus
- Jessica Badger
- Jeanne Marie Baffa
- Georgia Simone Bafundo
All providers in Wilmington, DE · Nurse Practitioner in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2016. 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.