MRS. STACY LYNN PARK (NPI# 1205012234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205012234 |
| Entity Type | Individual |
| Full Name | MRS. STACY LYNN PARK |
| Credential | FNP |
| Practice Address |
721 Glenwood Dr Suite 462a Chattanooga TN 37404-1106 |
| Practice Telephone | 4236242611 |
| Mailing Telephone | 4236242611 |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000012977 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841475 | Stacy Shoemake Park | Pharmacist | 6435 Bells Ferry Rd, Woodstock, GA 30189-2317 | 2020-11-04 |
| 1205290459 | Stacy Park | Pharmacist | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2016-04-13 |
| 1992961197 | Stacy Park | Social Worker | 1730 W Olympic Blvd Fl 3a-100, Los Angeles, CA 90015-1019 | 2008-08-06 |
| 1326115916 | Stacy Prince Park | Social Worker | 240 W Tyrone Rd, Oak Ridge, TN 37830-6517 | 2006-11-29 |
| Street Address |
721 GLENWOOD DR SUITE 462A |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37404-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861486839 | John L Gwin Jr. | Specialist | 721 Glenwood Dr, Suite 553, Chattanooga, TN 37404-1106 | 2005-09-07 |
| 1962848713 | Kadrie Partners | Psychiatry & Neurology | 721 Glenwood Dr, Suite 467 West, Chattanooga, TN 37404-1106 | 2013-05-21 |
| 1487901278 | Cannon & Cannon Medical, Pllc | Internal Medicine | 721 Glenwood Dr, Suite W-462, Chattanooga, TN 37404-1149 | 2012-08-10 |
| 1396989786 | Nathan Brantley Wyatt | Psychiatry & Neurology | 721 Glenwood Dr, Suite 467, Chattanooga, TN 37404-1106 | 2009-04-29 |
| 1952574931 | Tareck A. Kadrie, M.d., Pllc | Psychiatry & Neurology | 721 Glenwood Dr, Suite 467 West, Chattanooga, TN 37404-1106 | 2008-04-10 |
| 1104017607 | Gi Consultants, PC | Internal Medicine | 721 Glenwood Dr, Ste. W552, Chattanooga, TN 37404-1106 | 2007-08-08 |
| 1881885960 | Douglas L. Vanderbilt, M.d.,p.c. | Surgery | 721 Glenwood Dr, Memorial Medical Bldg., West Suite 470, Chattanooga, TN 37404-1106 | 2007-08-05 |
| 1528184744 | Chattanooga Surgical Oncology and Associates, Pllc | Surgery | 721 Glenwood Dr, Suite 471w, Chattanooga, TN 37404-1106 | 2007-03-21 |
| 1740339936 | Alan F. Shikoh, M.d., P.c | Internal Medicine | 721 Glenwood Dr, Suite W473, Chattanooga, TN 37404-1106 | 2007-01-09 |
| 1609946748 | Robert M. Barnett, IIi, Md | Surgery | 721 Glenwood Dr, Suite W460, Chattanooga, TN 37404-1106 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306494216 | Cynthia Caffey | Technician | 1305 E. 28th St. Apt A, Chatta, TN 37404 | 2019-09-04 |
| 1851944482 | Stacey Stokes | Peer Specialist | 1413 Bailey Ave, Chattanooga, TN 37404 | 2019-07-23 |
| 1306354790 | Erlanger Behavioral Health, LLC | Psychiatric Hospital | 804 North Holtzclaw Avenue, Chattanooga, TN 37404 | 2018-01-19 |
| 1245746171 | Davis Supportive Living Home Inc. | Custodial Care Facility | 1106 Duncan Avenue, Chattanooga, TN 37404 | 2017-12-14 |
| 1124544762 | Rachael Anne Maciver | Nurse Practitioner | 1909 South Willow Street, Chattanooga, TN 37404 | 2017-08-15 |
| 1447796214 | Esli Castillo | Nurse Practitioner | 281 N.lyerly St., Suite 200, Chattanooga, TN 37404 | 2017-01-17 |
| 1922542158 | Natasha Elliott | Community Health Worker | 2804 Cannon Ave, Chattanooga, TN 37404 | 2016-12-07 |
| 1730630153 | Jonathan Easter | Taxi | 1611 Anderson Avenue, Apt A, Chattanooga, TN 37404 | 2016-10-20 |
| 1477946143 | Thomas Jereme Holcomb | Nurse Practitioner | 281 N. Lyerly St, Suite 200, Chattanooga, TN 37404 | 2015-03-05 |
| 1922426709 | Sarah Mccary Baker | Internal Medicine | 605 Glenwood Drive, Suite 300, Chattanooga Internal Medicine Group, Chattanooga, TN 37404 | 2014-03-31 |
| Find all providers in zip 37404 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043828692 | Michelle Colby | Nurse Practitioner | 1050 Givens Rd, Chattanooga, TN 37421-4370 | 2020-07-20 |
| 1750999553 | Julia Clare Cervantes Aguilar | Nurse Practitioner | 3756 Knollwood Dr, Chattanooga, TN 37415-4203 | 2020-07-17 |
| 1447876743 | Cathleen Marie Cornett | Nurse Practitioner | 979 E 3rd St Ste C-300, Chattanooga, TN 37403-2136 | 2020-06-23 |
| 1487279139 | Roxy Gazaway | Nurse Practitioner | 721 Glenwood Dr Ste W560, Chattanooga, TN 37404-1129 | 2020-06-09 |
| 1801410253 | Stacey Buckner | Nurse Practitioner | 207 Booth Rd, Chattanooga, TN 37411-2702 | 2020-06-02 |
| 1073158630 | Jerry Lynn Reed Jr. | Nurse Practitioner | 7480 Ziegler Rd Ste 150, Chattanooga, TN 37421-4947 | 2019-11-07 |
| 1508411729 | Jerin C Alexander | Nurse Practitioner | 6918 Shallowford Rd Ste 226, Chattanooga, TN 37421-1552 | 2019-08-05 |
| 1295388841 | Ann Mercy Binoy | Nurse Practitioner | 425 Cumberland St # 110, Chattanooga, TN 37404-1909 | 2019-07-23 |
| 1528610466 | Kristina Wagner Daly | Nurse Practitioner | 504 E 17th St, Chattanooga, TN 37408-2107 | 2019-07-11 |
| 1023679909 | Megan Elizabeth Coffey | Nurse Practitioner | 3321 Montview Dr, Chattanooga, TN 37411-3524 | 2019-06-22 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37404 |
Please comment or provide details below to improve the information on MRS. STACY LYNN PARK.
| 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.