STACY RAE ANDREACCHIO (NPI# 1700865235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700865235 |
| Entity Type | Individual |
| Full Name | STACY RAE ANDREACCHIO |
| Credential | FPMHNP |
| Practice Address |
5004 Highway 39 N Meridian MS 39301-1021 |
| Mailing Address |
Po Box 8068 Meridian MS 39303-8068 |
| Practice Telephone | 6016938307 |
| Practice Fax Number | 6016936794 |
| Mailing Telephone | 6016938307 |
| Mailing Fax Number | 6016396794 |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2008-05-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R828589 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08903768 | 05 |
| Street Address |
5004 HIGHWAY 39 N |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301-1021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881254837 | Jennifer Michelle Alford | Counselor | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2019-06-20 |
| 1760906846 | Lindsey Stevens Blount | Nurse Practitioner | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2017-07-31 |
| 1619348182 | Jessica Richardson | Counselor | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2015-10-09 |
| 1124234307 | Patricia Lynn Dudley | Psychiatry & Neurology | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2007-05-15 |
| 1104931930 | Rosanne Nunnery | Counselor | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2006-08-20 |
| 1386657914 | Michelle Denise Boucher-snodgrass | Psychologist | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2006-08-14 |
| 1558382101 | Jennifer F Whitcomb | Counselor | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2006-07-21 |
| 1881673317 | Patricia M Sandusky | Psychologist | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2006-01-12 |
| 1154300663 | Kenneth R Schneider | Psychologist | 5004 Highway 39 N, Meridian, MS 39301-1021 | 2006-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1386020592 | Evelyn Michele Dunn | Nurse Practitioner | 10641 Highway 80 East, Meridian, MS 39307-9256 | 2015-08-11 |
| 1174909865 | Priscilla May Mathis | Nurse Practitioner | 4973 C A Pickard Rd, Meridian, MS 39301-9031 | 2015-08-04 |
| 1134497464 | Rebekah Danielle Nation | Nurse Practitioner | 1404 N Main St, Suite 101, Meridian, ID 83642-2799 | 2011-12-01 |
| 1053691980 | Carrie Kay Bowman | Nurse Practitioner | 1944 N Hillmont Ave, Meridian, ID 83646-1385 | 2011-08-23 |
| 1205461167 | Portia Elaine Nunley | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301-8205 | 2020-03-10 |
| 1770116030 | Briana Shanee Brunson | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-02-14 |
| 1629600721 | Shauntae Causey | Nurse Practitioner | 5000 Highway 39 N, Meridian, MS 39301-1021 | 2020-02-06 |
| 1619507407 | Brenda A Thompson | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-01-21 |
| 1205466414 | Arlene Edwards | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-01-16 |
| Find all providers in MERIDIAN | ||||
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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.