National Provider Identifier Database

STACEY BASTA, FNP-C – NPI #1770533663
Family


Contact Information

STACEY BASTA, FNP-C
4050 N GEORGE STREET EXT
MANCHESTER, PA17345-9347
Phone: 717-356-4370
Fax: 717-260-3316
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for STACEY BASTA

NPI Number 1770533663
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 05/11/2006
Last updated 01/13/2025 - More than a year ago
Sole proprietor1 No
Identifiers
  • MD License #: R155699
  • PA License #: SP009717
Hospital affiliation n/a

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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