MRS. NANCY PELLEGRINO STAM (NPI# 1235370891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235370891 |
| Entity Type | Individual |
| Full Name | MRS. NANCY PELLEGRINO STAM |
| Credential | PMHNP |
| Practice Address |
1340 S Waldron Rd Fort Smith AR 72903-2556 |
| Mailing Address |
Po Box 23070 Barling AR 72923-0070 |
| Practice Telephone | 4794525040 |
| Practice Fax Number | 4794525047 |
| Mailing Telephone | 4794525040 |
| Mailing Fax Number | 4794525047 |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 048 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
148 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2010005264 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SP0810X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Family |
A004937 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 875 W. Moreno Ave, Colorado Springs, CO 80905 | 7195726100 | 5405351155 |
| Street Address |
1340 S WALDRON RD |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72903-2556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295780088 | Terrence William Mcknight | Counselor | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2006-05-23 |
| 1093367138 | Chelsea Neal | Case Manager/Care Coordinator | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2019-07-09 |
| 1528526282 | Amber Flesher | Counselor | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2019-03-12 |
| 1821582446 | Caylee Garner | Case Manager/Care Coordinator | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2018-06-18 |
| 1215432364 | Lauren Post | Case Manager/Care Coordinator | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2018-03-29 |
| 1487167045 | Jeremy Henson | Counselor | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2017-11-06 |
| 1255843223 | Kyley Hood | Counselor | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2017-10-31 |
| 1992216519 | Jessica Nicole Swaim | Case Manager/Care Coordinator | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2017-10-23 |
| 1598276115 | Marsha Leanne Williams | Case Manager/Care Coordinator | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2017-10-23 |
| 1124540620 | Julia Marchese | Case Manager/Care Coordinator | 1340 S Waldron Rd, Fort Smith, AR 72903-2556 | 2017-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285280016 | Bhg L, LLC | Clinic/Center | 1501 Waldron Road, Ste 203, Fort Smith, AR 72903 | 2019-08-16 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1083272223 | Pediatric Therapy Connections LLC | Clinic/Center | 7601 Westminister Pl, Fort Smith, AR 72903 | 2019-06-03 |
| 1073092821 | Baptist Health Services | Psychiatry & Neurology | 3808 Gary St Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1104305853 | Baptist Health Services | Family Medicine | 5428 Ellsworth Rd Ste A, Fort Smith, AR 72903 | 2018-08-13 |
| 1417436171 | Baptist Health Services | Pediatrics | 5428 Ellsworth Rd Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1558840421 | Baptist Health Services | Family Medicine | 3808 Gary St Ste A, Fort Smith, AR 72903 | 2018-08-10 |
| 1316434707 | Md Weight Loss and Wellness, LLC | Dietitian, Registered | 3416 Old Greenwood Road, Fort Smith, AR 72903 | 2018-04-20 |
| 1942695572 | Donna K Morgan | Counselor | 2408 S. 51st Court Suite G, Fort Smith, AR 72903 | 2015-03-31 |
| 1346658242 | Shelby Mural Esry | Dentist | 3200 Rogers Ave. Suite 111, Fort Smith, AR 72903 | 2014-07-24 |
| Find all providers in zip 72903 | ||||
| Taxonomy Code | 364SP0810X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Child & Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982031514 | Rebecca Burke | Clinical Nurse Specialist | 9914 Interstate 30, Dayspring Behavioral Health System, Little Rock, AR 72209-4201 | 2013-09-27 |
| City | FORT SMITH |
| Zip Code | 72903 |
Please comment or provide details below to improve the information on MRS. NANCY PELLEGRINO STAM.
| 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.