STACY R FOGLE (NPI# 1376093278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376093278 |
| Entity Type | Individual |
| Full Name | STACY R FOGLE |
| Credential | FNP-C |
| Practice Address |
2990 N Broadway Ave Tyler TX 75702-2149 |
| Mailing Address |
Po Box 844273 Dallas TX 75284-4273 |
| Practice Telephone | 9035931892 |
| Practice Fax Number | 9035923886 |
| Mailing Telephone | 9035315000 |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2019-11-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP132078 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2990 N BROADWAY AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75702-2149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043206147 | Jacqueline Catney Dubois | Pediatrics | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2005-09-23 |
| 1780169300 | Perla Cornelio Lopez | Nurse Practitioner | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2018-09-28 |
| 1346739778 | Rita Ekpen Ozomah | Nurse Practitioner | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2018-05-01 |
| 1548663784 | Lamesa Bell | Nurse Practitioner | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2014-10-02 |
| 1780944033 | Amber N Cook | Family Medicine | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2012-05-21 |
| 1831360304 | Chijioke F Isinguzo | Emergency Medicine | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2008-03-12 |
| 1225215395 | Shari Elizabeth Bass | Pediatrics | 2990 N Broadway Ave, Tyler, TX 75702 | 2008-01-30 |
| 1285848234 | Don Earl Horn | Social Worker | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2007-05-09 |
| 1790999779 | Glenda Butler Mccloud | Registered Nurse | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2007-05-09 |
| 1962520585 | Mother France Hospital | Case Management | 2990 N Broadway Ave, Tyler, TX 75702-2149 | 2007-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329728 | Rachel E Fouse | Nurse Practitioner | 323 S Fannin Ave, Tyler, TX 75702-7321 | 2020-02-29 |
| 1942845243 | Nicolette Jane Silverio | Nurse Practitioner | 6116 Wilshire Dr, Tyler, TX 75703-4160 | 2019-11-10 |
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1356996573 | Katy Sutton | Nurse Practitioner | 1901 Belmont Dr, Tyler, TX 75701-4338 | 2019-08-05 |
| 1063067577 | Elnora King | Nurse Practitioner | 1600 Rice Rd Apt 1117, Tyler, TX 75703-3308 | 2019-08-02 |
| 1851959472 | Tx Np Health, Pllc | Nurse Practitioner | 21755 Syrah Ln, Tyler, TX 75703-9274 | 2019-05-29 |
| 1114482569 | Carolyn Johnson | Nurse Practitioner | 13462 Hwy 110 N, Tyler, TX 75704-2444 | 2019-02-08 |
| 1720543556 | Kelsey Danielle Sheeley | Nurse Practitioner | 6770 Old Jacksonville Hwy Ste 103, Tyler, TX 75703-0576 | 2019-02-06 |
| 1790257392 | Tiffany Yvette Gardner | Nurse Practitioner | 301 Fm 757, Tyler, TX 75705-4503 | 2018-12-20 |
| 1174023352 | Jonathan Brice King | Nurse Practitioner | 721 Clinic Dr # A, Tyler, TX 75701-2043 | 2018-02-14 |
| Find all providers in TYLER | ||||
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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.