TRACI M STAFFORD (NPI# 1639700602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639700602 |
| Entity Type | Individual |
| Full Name | TRACI M STAFFORD |
| Credential | CRNP |
| Practice Address |
1118 Ross Clark Cir Ste 100 Dothan AL 36301-3023 |
| Practice Telephone | 3347941148 |
| Practice Fax Number | 3347931954 |
| Mailing Telephone | 3347941148 |
| Mailing Fax Number | 3347931954 |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-122428 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1118 ROSS CLARK CIR STE 100 |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-3023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811390396 | Emily Brooke Pettis | Nurse Practitioner | 1118 Ross Clark Cir Ste 100, Dothan, AL 36301-3023 | 2014-09-29 |
| 1780218123 | Amber Stewart | Nurse Practitioner | 1118 Ross Clark Cir Ste 100, Dothan, AL 36301-3023 | 2020-02-25 |
| 1568020949 | Alyse Marie Murkerson | Nurse Practitioner | 1118 Ross Clark Cir Ste 100, Dothan, AL 36301-3023 | 2019-05-31 |
| 1235621384 | Victoria Nichole Hatcher | Nurse Practitioner | 1118 Ross Clark Cir Ste 100, Dothan, AL 36301 | 2018-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295362408 | Stephen M Pendergraft | Nurse Practitioner | 4740 W Main St, Dothan, AL 36305-9423 | 2020-03-26 |
| 1689205767 | Sassy Lashawn Sylvester | Nurse Practitioner | 410 Ridgeland Rd, Dothan, AL 36301-1117 | 2020-01-28 |
| 1700344488 | Gregory Keith Tice | Nurse Practitioner | 1118 Ross Clark Cir Ste 704, Dothan, AL 36301-3030 | 2019-03-12 |
| 1144732520 | Kasey Duffie Chance | Nurse Practitioner | 211 Brushfire Dr, Dothan, AL 36305-7069 | 2017-10-25 |
| 1306364062 | Janeetra Janiece Coachman | Nurse Practitioner | 9 Trillium Cir Apt 1401, Dothan, AL 36301-7653 | 2017-09-01 |
| 1265954010 | Melanie Jo Ellison | Nurse Practitioner | 973 Dunn Rd, Dothan, AL 36303-1056 | 2017-07-13 |
| 1679012629 | Elva Calderon | Nurse Practitioner | 1736 E Main St Ste 100, Dothan, AL 36301-3040 | 2017-02-22 |
| 1649610395 | Kelli Saage Anderson | Nurse Practitioner | 1146 Ross Clark Cir, Dothan, AL 36301-3022 | 2013-06-26 |
| 1902040090 | Cindy Ruth Hemendinger | Nurse Practitioner | 3124 Ross Clark Cir, Dothan, AL 36303-3038 | 2009-04-21 |
| 1770737249 | Kelley E Blake | Nurse Practitioner | 4300 W Main St Ste 45, Dothan, AL 36305-1317 | 2008-11-11 |
| Find all providers in DOTHAN | ||||
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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.