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Alexis Olivia Stambaugh

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2102 Harrisburg Pike, Lancaster, PA 17601-2644

PECOS Enrollment

This provider is enrolled in PECOS as ALEXIS STAMBAUGH.

Based on the most recent information from CMS, provider Alexis Olivia Stambaugh is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1003681362
Provider Type
Individual
Full Name
Stambaugh, Alexis Olivia
Title
Mrs.
Credential
CRNP

Gender
Female
Sole Proprietor
No
Enumeration Date
11/16/2023
Last Updated
11/16/2023

Contact Information

Practice Location

2102 Harrisburg Pike, Lancaster, PA 17601-2644

(717) 544-9400

Unlisted Fax

Mailing Location

521 N President Ave, Lancaster, PA 17603-2601

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License SP028719 Pennsylvania
Code 2086X0206X	Description Surgery Allopathic & Osteopathic Physicians	License SP028719 Pennsylvania

Alexis Olivia Stambaugh

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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