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Contact Information

STACY JERVIS, FNP-BC, MED, CNRN
2508 EDGEMONT DR STE 2
ARKANSAS CITY, KS67005-3844
 Phone: 620-442-7120
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Neuroscience

163WN0800X
Indicates primary specialty

NPI Profile & details for STACY JERVIS · (Female)

NPI # 1538569199
Status Active
Credentials FNP-BC, MED, CNRN
Entity Individual
Enumeration date 09/01/2014
Last updated 02/07/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • KS License # 14-127265-032
  • KS License # 53-76375-032
  • KS Medicaid KA5478001
Hospital affiliation(s)
  • SOUTH CENTRAL KS MED CENTER - (Acute Care)
    6401 PATTERSON PARKWAY
    ARKANSAS CITY, KS 67005
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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