| Doctor Name: | MRS. STACY MARIE HASTEY |
| NPI Number: | 1477788891 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD/LD |
| License Number: | 1617 |
| Business Practice Address: | 20658 Cedar Rd Henryetta, OK - 744377289 |
| Business Phone Number: | 9186525523 |
| Business Fax Number: | 9186500270 |
| Mailing Address: | 114 N Grand Ave, Suite 310 OKMULGEE |
| State: | OK |
| Postal Code: | 744474013 |
| Phone Number: | 9187565560 |
| Fax Number: | 9187565589 |
| NPI Enumeration Date: | 05/29/2009 |
| NPI Last Update Date: | 01/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 1617 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |