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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 Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for STACEY BASTA · (Female)

NPI Number 1770533663
Status Active
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 proprietor 1 No
Identifiers
  • MD License # R155699
  • PA License # SP009717
Hospital affiliation(s) Not Available
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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