STACEY TAYLOR (NPI# 1063860914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063860914 |
| Entity Type | Individual |
| Full Name | STACEY TAYLOR |
| Credential | FNP |
| Practice Address |
4201 Saint Antoine St Ste 5c Detroit MI 48201-2153 |
| Mailing Address |
1560 E Maple Road Suite 400 - Credentialing Troy MI 48083-1138 |
| Practice Telephone | 3137457999 |
| Practice Fax Number | 3139666400 |
| Mailing Telephone | 3137457999 |
| Mailing Fax Number | 3139666400 |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704246188 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205049269 | Stacey Weldon Taylor | Mechanotherapist | 7109 29th Ave Sw, Seattle, WA 98126 | 2007-05-07 |
| 1306925078 | Stacey Lynn Taylor | Physical Therapist | 5909 Bethel Rd, Shawnee, OK 74804-0915 | 2006-11-03 |
| 1588158976 | Stacey Erin Taylor | Licensed Practical Nurse | 3322 Broadway, Everett, WA 98201-4425 | 2018-06-19 |
| 1093260655 | Stacey Taylor | Occupational Therapist | 9205 Sw Barnes Rd, Providence Children's Development Institute, Portland, OR 97225-6603 | 2016-08-23 |
| 1932576261 | Stacey Taylor | Social Worker | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2015-08-21 |
| 1861897456 | Stacey Marie Taylor | Nurse Practitioner | 25 Church St, Wilkes Barre, PA 18765-0999 | 2014-10-26 |
| 1609270958 | Stacey Taylor | Social Worker | 4000 E Charleston Blvd Ste 230, Las Vegas, NV 89104-6682 | 2014-10-15 |
| 1568769602 | Stacey L Taylor | Physical Therapist | 9300 Weber Park Pl, Room 225, Skokie, IL 60077-4200 | 2011-02-25 |
| 1790970820 | Stacey L Taylor | Counselor | 1005 Brookside Rd, Suite 330, Allentown, PA 18106-9023 | 2007-09-11 |
| 1417163437 | Stacey Marie Taylor | Counselor | 1664 Broadway, El Cajon, CA 92021-5201 | 2007-05-15 |
| Street Address |
4201 SAINT ANTOINE ST STE 5C |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518087956 | Mariam Ahmad Hazem | Internal Medicine | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201-2153 | 2007-03-30 |
| 1558909994 | Augustina Obi | Nurse Practitioner | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201-2153 | 2019-12-17 |
| 1093379828 | Hebatalla Osman | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201-2153 | 2019-04-26 |
| 1336672088 | Nooraldin Merza | Hospitalist | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201-2153 | 2017-04-10 |
| 1164836516 | Eugene Verkhovsky | Internal Medicine | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201-2153 | 2014-06-13 |
| 1245658202 | Brian Rutledge | Internal Medicine | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201-2153 | 2014-04-06 |
| 1487072559 | Bassam Bader | Internal Medicine | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201-2153 | 2014-04-04 |
| 1023456324 | Harsh Rohit Shah | Internal Medicine | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201 | 2013-06-07 |
| 1982910527 | Mohammad Fahad Bin Asad | Internal Medicine | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201-2153 | 2010-08-20 |
| 1861712127 | Meghann Lynn Schenk | Internal Medicine | 4201 Saint Antoine St Ste 5c, Detroit, MI 48201 | 2010-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386243574 | Carl Andrew Ballard | Nurse Practitioner | 2635 Johnson Bottom Rd, Detroit, AL 35552-2731 | 2020-10-20 |
| 1639776164 | Jennifer N Fucile | Nurse Practitioner | 3800 Woodward Ave Apt 702, Detroit, MI 48201-1980 | 2020-10-07 |
| 1649880329 | Dedra Delane Ford | Nurse Practitioner | 18255 Birchcrest Dr, Detroit, MI 48221-2750 | 2020-08-06 |
| 1528695624 | Venvisor Health Michigan LLC | Nurse Practitioner | 400 Renaissance Ctr Ste 200, Detroit, MI 48243-1502 | 2020-03-26 |
| 1558909978 | Ruxandra Maria Lazar | Nurse Practitioner | 5285 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2019-12-16 |
| 1376186460 | Fazila Mahmood Siddiqui | Nurse Practitioner | 22201 Moross Rd Bldg Suite380, Detroit, MI 48236-2169 | 2019-10-22 |
| 1205482692 | Ladawn Denise Kennedy | Nurse Practitioner | 16645 Ilene St, Detroit, MI 48221-3401 | 2019-08-13 |
| 1427600246 | Christina Neirinck | Nurse Practitioner | 2401 St Antoine St, Detroit, MI 48201 | 2019-07-11 |
| 1548821556 | Ty R Houston | Nurse Practitioner | 13100 Corbett St, Detroit, MI 48213-2081 | 2019-06-21 |
| 1235795451 | Nekisha Bailey | Nurse Practitioner | 7501 Parkland, Detroit, MI 48239-1079 | 2019-05-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.