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MR. STACY WAYNE JEFFERSON LPN-IV
NPI 1861645574
Licensed Practical Nurse in Georgetown, OH

Active since October 25, 2008
432 N GREEN ST, GEORGETOWN, OH 45121(937) 213-0588 Get Directions Write a Review

NPPES record last updated: October 25, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Stacy Wayne Jefferson Lpn-iv NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. STACY WAYNE JEFFERSON LPN-IV (NPI 1861645574) is an individual licensed practical nurse in Georgetown, Ohio, licensed in Ohio (PN127734 IV) and active in the NPI registry since October 2008.

NPPES Registry Identity

NPI1861645574
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameMR. STACY WAYNE JEFFERSONCredential: LPN-IV
Location Address432 N GREEN STGeorgetown, OH 45121-1011
Mailing Address432 N Green StGeorgetown, OH 45121-1011 · (937) 213-0588
Phone(937) 213-0588
Sole ProprietorYes
Enumeration DateOctober 25, 2008
✔ NPI 1861645574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in OH · PN127734 IV
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
432 N GREEN ST, Georgetown, OH 45121
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

APRIL C JEFFERSON S.T.N.A.
Nurse's Aide
432 N GREEN ST
GEORGETOWN, OH 45121
Brown County (937) 213-1380

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Jefferson's NPI number?

The NPI number for Stacy Jefferson is 1861645574. It was assigned to this individual provider in the NPPES registry on October 25, 2008.

Where is Stacy Jefferson located?

Stacy Jefferson practices at 432 N Green St, Georgetown, OH 45121. The listed phone number is (937) 213-0588.

What is Stacy Jefferson's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Stacy Jefferson was last updated on October 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.