MRS. STACEY HARRIS TADLOCK (NPI# 1639684848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639684848 |
| Entity Type | Individual |
| Full Name | MRS. STACEY HARRIS TADLOCK |
| Credential | FNP-BC |
| Practice Address |
3000 Coliseum Dr Ste 200 Hampton VA 23666-5963 |
| Practice Telephone | 7577367280 |
| Mailing Telephone | 7577367280 |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2017-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024175455 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3000 COLISEUM DR STE 200 |
| City | HAMPTON |
| State | VA |
| Zip Code | 23666-5963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720052285 | Gregory P Fitzharris | Colon & Rectal Surgery | 3000 Coliseum Dr Ste 200, Hampton, VA 23666-5963 | 2006-02-13 |
| 1366700684 | Kenneth Sadler Meyers | Surgery | 3000 Coliseum Dr Ste 200, Hampton, VA 23666-5963 | 2012-04-24 |
| 1356523641 | Sentara Medical Group | Surgery | 3000 Coliseum Dr Ste 200, Hampton, VA 23666-5963 | 2007-11-29 |
| 1720055395 | Pragna N Shah | Family Medicine | 3000 Coliseum Dr Ste 200, Hampton, VA 23666 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548824022 | Melanin Excellence Medical Transportation Co LLC | Non-emergency Medical Transport (VAN) | 4418 East Claiborne Sq, Suite 334, Hampton, VA 23666 | 2019-04-30 |
| 1952880502 | Exquisite Counseling Services LLC | Counselor | 2703 Build America Drive, Hampton, VA 23666 | 2018-08-13 |
| 1063999811 | Speak From The Heart | Speech-Language Pathologist | 2 Abbott Dr, Hampton, VA 23666 | 2018-07-24 |
| 1245724632 | Drashti Khamar | Dentist | 2040 Coliseum Dr # A27, Hampton, VA 23666 | 2018-06-19 |
| 1750874772 | Dion J Roszina | Private Vehicle | 806 Charlton,dr, Hampton, VA 23666 | 2018-06-13 |
| 1205352481 | Crystal Lynn Harris | Counselor | 2021 Cunningham Drive, Suite 400, Hampton, VA 23666 | 2017-08-18 |
| 1538693361 | Marquis A. Norton | Counselor | 4410 East Claiborne Street, Suite 334, Hampton, VA 23666 | 2017-04-18 |
| 1194181966 | Key Elements Care, LLC | Case Management | 20 Research Dr Ste 600, Hampton, VA 23666 | 2016-01-11 |
| 1740665215 | Lauren-grey Gonzales Igel | Hearing Instrument Specialist | 1507 Hardy Cash Drive, Hampton, VA 23666 | 2015-07-27 |
| 1457758062 | Alexandra Levine | Acupuncturist | 2216 Executive Dr Ste A, Hampton, VA 23666 | 2014-11-25 |
| Find all providers in zip 23666 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457967960 | Nicole Andrea Crawford | Nurse Practitioner | 1131 Misty Meadows Xing, Hampton, GA 30228-6191 | 2020-09-20 |
| 1255958047 | Terri Dejuana Gilliam | Nurse Practitioner | 23 Northcutt Dr, Hampton, VA 23664-1179 | 2020-06-29 |
| 1679196166 | Mutinta Matimba Hamuwele | Nurse Practitioner | 10988 Genova Ter, Hampton, GA 30228 | 2020-05-19 |
| 1225669138 | Ingrid J Ortiz | Nurse Practitioner | 4000 Coliseum Dr Ste 300, Hampton, VA 23666-5974 | 2020-01-29 |
| 1184195562 | Sharee Lashell Stowes | Nurse Practitioner | 915 Gloucester St, Hampton, VA 23661-2203 | 2018-12-11 |
| 1841767035 | Jasmine Macheryl Webb | Nurse Practitioner | 1146 Oak Hollow Ct, Hampton, GA 30228-5571 | 2018-10-26 |
| 1760966337 | Misty Spencer | Nurse Practitioner | 11850 Hastings Bridge Rd, Hampton, GA 30228-6276 | 2018-09-19 |
| 1598246878 | Emma Ledbetter | Nurse Practitioner | 1910 Elm Park Dr, Hampton, GA 30228 | 2018-08-24 |
| 1588155055 | Premium Care Health, LLC | Nurse Practitioner | 1684 Thorn Ridge Trl, Hampton, GA 30228-6129 | 2018-05-21 |
| 1588103782 | Diverse Healthcare Inc | Nurse Practitioner | 509 Wine St, Hampton, VA 23669-3162 | 2017-02-21 |
| Find all providers in HAMPTON | ||||
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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.