Provider Demographics
NPI:1871350561
Name:IRBY, STACY FELICIA
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:FELICIA
Last Name:IRBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20390 BROOKSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4965
Mailing Address - Country:US
Mailing Address - Phone:313-405-2494
Mailing Address - Fax:
Practice Address - Street 1:14055 ASBURY PARK
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-1387
Practice Address - Country:US
Practice Address - Phone:313-405-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide