| Doctor Name: | STACIA N. BRISCOE |
| NPI Number: | 1073756268 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 2008011837 |
| Business Practice Address: | 1000 Central Street Labelle, MO - 63447 |
| Business Phone Number: | 6604623266 |
| Business Fax Number: | |
| Mailing Address: | 1025 Maine St, QUINCY |
| State: | IL |
| Postal Code: | 623014038 |
| Phone Number: | 2172226550 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2009 |
| NPI Last Update Date: | 02/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2008011837 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |