STACEY JACKSON (NPI# 1134645674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134645674 |
Entity Type | Individual |
Full Name | STACEY JACKSON |
Credential | FNP-C |
Practice Address |
1604 Hospital Pkwy Ste 100 Bedford TX 76022-5913 |
Practice Telephone | 8178482880 |
Practice Fax Number | 8178482890 |
Mailing Telephone | 8178482880 |
Mailing Fax Number | 8178482890 |
Enumeration Date | 2017-08-16 |
Last Update Date | 2019-11-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP134528 | TX | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588189310 | Stacey Marie Jackson | Psychologist | 11 Nealy Blvd, Hampton, VA 23665 | 2017-08-14 |
1508301292 | Stacey Jackson | Registered Nurse | 1015 S Broadway, Suite 18, Minot, ND 58701-4667 | 2017-01-04 |
1669828224 | Stacey Renee Jackson | Nurse Practitioner | 906 W Randol Mill Rd, Arlington, TX 76012-2510 | 2016-05-12 |
1497142459 | Stacey Ann Jackson | Nurse Practitioner | 1010 Central Avenue, Suite 2, Billings, MT 59102 | 2015-04-16 |
1760807234 | Stacey Renea Jackson | Counselor | 619 N Main St, Muskogee, OK 74401-4431 | 2014-02-20 |
1477849826 | Stacey Jo Jackson | Specialist | 17 S Central Ave, Idabel, OK 74745-4625 | 2011-06-23 |
1790926905 | Stacey L. Jackson | Counselor | 191 Memorial Dr, Pacolet, SC 29372-2255 | 2009-03-18 |
1578722278 | Stacey Marie Jackson | Physical Therapy Assistant | 4680 Cordata Pkwy, Bellingham, WA 98226-8038 | 2008-06-06 |
1659562692 | Stacey Lajune Jackson | Psychologist | 110 Eagles Walk, Ste. 100, Stockbridge, GA 30281-7204 | 2007-08-06 |
1457470726 | Stacey A Jackson | Pharmacist | 3301 Gordon Dr, Sioux City, IA 51105-3708 | 2007-03-28 |
Street Address |
1604 HOSPITAL PKWY STE 100 |
City | BEDFORD |
State | TX |
Zip Code | 76022-5913 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194700344 | Lorraine F Kreider | Internal Medicine | 1604 Hospital Pkwy Ste 100, Bedford, TX 76022-5913 | 2005-12-09 |
1467415695 | Sherif Y Hanna | Internal Medicine | 1604 Hospital Pkwy Ste 100, Bedford, TX 76022-5913 | 2006-04-10 |
1104889336 | Barry J Alldredge | Internal Medicine | 1604 Hospital Pkwy Ste 100, Bedford, TX 76022-5913 | 2006-04-10 |
1841252418 | Sunitha Siram | Internal Medicine | 1604 Hospital Pkwy Ste 100, Bedford, TX 76022-5913 | 2006-04-06 |
1821067083 | Krishnaveni Bethi | Internal Medicine | 1604 Hospital Pkwy Ste 100, Bedford, TX 76022-5913 | 2006-03-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376155754 | Jacquelyn H Holloway | Registered Nurse | 820 Uptown Blvd, Bedrord, TX 76022 | 2020-08-18 |
1861972556 | Red Diamond Medical Group Pllc | Internal Medicine | 2700 Tibbets Dr # 301, Bedford, TX 76022 | 2018-08-21 |
1649761958 | Florine Karimi Mati | Behavioral Analyst | 1413 Tennis Dr, Bedford, TX 76022 | 2018-05-22 |
1760836704 | Healing Hands Senior Care Service | Technician | 1152 High Point Rd., Bedford, TX 76022 | 2016-04-15 |
1972965283 | Emily Vandoren | Physical Therapist | 1705 Forest Ridge Drive, Bedford, TX 76022 | 2016-03-25 |
1396123949 | Decorla Holmes | Adult Companion | 1152 Highpoint Rd., Bedford, TX 76022 | 2015-05-15 |
1629409198 | Susan Yvonne Pelletier | Durable Medical Equipment & Medical Supplies | 1600 Central Drive, Suite 157, Bedford, TX 76022 | 2013-12-09 |
1649565953 | Alisa Thamwiwat | Internal Medicine | 1604 Hospital Pkwy Ste 301, Bedford, TX 76022 | 2011-06-15 |
1528227576 | Ft. Worth Home Care Inc | Home Health | 1600 Airport Freeway, Suite 503, Bedford, TX 76022 | 2008-06-05 |
1225242886 | Bedford Family Medicine, Pa | Family Medicine | 1701 Forest Ridge Dr., Bedford, TX 76022 | 2007-05-10 |
Find all providers in zip 76022 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629680814 | Heather Jean Dozois | Nurse Practitioner | 80 Palomino Ln Ste 402, Bedford, NH 03110-6447 | 2020-08-19 |
1760004337 | Pamela Urick | Nurse Practitioner | 33 Darby Ln, Bedford, NH 03110-4517 | 2020-05-17 |
1710513932 | Nirmal Shrestha Deoju | Nurse Practitioner | 2345 Leafy Glen Ct, Bedford, TX 76022-6114 | 2020-03-19 |
1639729445 | Erin Lynn Dedman | Nurse Practitioner | 470 Us-421, Bedford, KY 40006 | 2019-09-13 |
1013495837 | Stephanie Ann Mason | Nurse Practitioner | 2415 Mitchell Rd Ste C, Bedford, IN 47421-4731 | 2018-08-02 |
1386121424 | Sara Elizabeth Kazanowski | Nurse Practitioner | 5 Washington Pl Ste 1a, Bedford, NH 03110-6771 | 2018-07-22 |
1144722539 | Leslie Stevens Kipp | Nurse Practitioner | 1305 Airport Fwy Ste 420, Bedford, TX 76021-6605 | 2018-03-01 |
1407370216 | Laura L Boulter | Nurse Practitioner | 154 Great Rd, Bedford, MA 01730-2725 | 2017-08-02 |
1003339623 | Kathryn Lynn Alto | Nurse Practitioner | 88 Center Rd Ste 250a, Bedford, OH 44146-2711 | 2017-07-25 |
1306399811 | Caitlin Wright | Nurse Practitioner | 2512b Q St, Bedford, IN 47421-4928 | 2016-08-01 |
Find all providers in BEDFORD |
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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.