Staples Health Clinic, LLC
Organization Active NPI Family Nurse Practitioner · Auburn, KY
NPI 1962867713 · NPPES record last updated Dec 21, 2015
Key facts
- NPI
- 1962867713
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3005699 (KY)
- Legal business name
- STAPLES HEALTH CLINIC, LLC
- Practice address
- 104 E Main St
Auburn, KY 42206-5106 - Phone
- (270) 438-3474
- NPI assigned
- Dec 21, 2015
- Organization subpart
- No
Authorized official
- Name
- Mrs. Stacia Staples, APRN
- Title
- Owner
- Phone
- (270) 438-3474
Practitioners 4
-
Stacia Ashley Staples, ARNP
-
Brianah L Doeden, APRN
-
James Marvin Staples, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160309002476 | KY | Part B Supplier - Clinic/Group Practice | 6406152925 |
Receives reassigned benefits from 3 practitioners Practice locations: Auburn, KY; Bowling Green, KY; Hopkinsville, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 3005699 | KY | Yes |
Addresses
Primary practice location
104 E Main St
Auburn, KY 42206-5106
Mailing address
PO Box 66
Auburn, KY 42206-0066
Phone (270) 438-3474
Other providers in Auburn, KY
- Krista Nash-Posey
- Cindy Pawley
- Stefanie Layne Shrull
- Jessica Smith
- Barry W Stahl
- James Marvin Staples
- Stacia Ashley Staples
- Tara Jackson
- TLC Caregivers
- Kristina M Wimpee
All providers in Auburn, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.