STACEY MICHELIN (NPI# 1750873089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750873089 |
| Entity Type | Individual |
| Full Name | STACEY MICHELIN |
| Other Name | STACEY BOOTHE |
| Credential | FNP-C |
| Practice Address |
215 8th St Clarksville TN 37040 |
| Mailing Address |
215 8th St Clarksville TN 37040-3249 |
| Practice Telephone | 9315429010 |
| Practice Fax Number | 9315429019 |
| Mailing Telephone | 9315429010 |
| Mailing Fax Number | 9315429010 |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2019-02-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
24149 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | IRS | 83-1860610 | 01 |
| Street Address |
215 8TH ST |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982779385 | John Thomas Clardy Sr. | Family Medicine | 215 8th St, Clarksville, TN 37040-3249 | 2006-11-21 |
| 1306496054 | Compass Family Health Clinic, Pllc | Family Medicine | 215 8th St, Clarksville, TN 37040-3249 | 2019-09-15 |
| 1154883189 | Tessa Kaye Morrison | Nurse Practitioner | 215 8th St, Clarksville, TN 37040-3249 | 2019-03-31 |
| 1215126644 | John T Clardy Sr Md Inc | Internal Medicine | 215 8th St, Clarksville, TN 37040-3249 | 2007-10-22 |
| 1043385453 | George Thomas Clardy Jr. | Family Medicine | 215 8th St, Clarksville, TN 37040-3249 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770124380 | Clarksville Treatment Center, LLC | Clinic/Center | 495 Dunlop Lane, Clarksville, TN 37040 | 2019-10-04 |
| 1295384956 | Dena Marie Borchick | Technician | 3779 Cindy Jo Dr. N, Clarksville, TN 37040 | 2019-09-05 |
| 1477014488 | Emily Allen | Dentist | 930 Hwy 76, Clarksville, TN 37040 | 2019-03-31 |
| 1730640566 | Latoya Ewert | Counselor | Centerstone Clarksville Harriet Cohn Center, 511 8th Street, Clarksville, TN 37040 | 2019-03-26 |
| 1356811988 | Jamie Coles | Behavior Technician | 851 Professional Park Drive 851 Profesiional Park Drive, Clarksville, TN 37040 | 2018-11-27 |
| 1518448554 | Bandel Counseling Service | Clinic/Center | 113 3rd St., Suite 25, Clarksville, TN 37040 | 2018-08-28 |
| 1477052520 | Bridget Stokes | Behavior Technician | 2277 Wilma Rudolph Blvd., Suite C #259, Clarksville, TN 37040 | 2018-02-05 |
| 1053824334 | Sandra Loren Coates | Nurse Practitioner | 980 Professional Park Dr Ste C, Clarksville, TN 37040 | 2017-11-09 |
| 1902328362 | Terri Brooke Roach | Registered Nurse | 651 Dunlop Lane, Clarksville, TN 37040 | 2017-07-07 |
| 1093244428 | Nikkia Deneil Bell | Behavior Technician | 139 E. Old Trenton Rd, Suite B, Clarksville, TN 37040 | 2017-06-08 |
| Find all providers in zip 37040 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043810849 | Olushola Taiwo Adekoya | Nurse Practitioner | 6909 Crossfield Ct, Clarksville, MD 21029-1749 | 2020-10-29 |
| 1497367981 | Kinjal Bhatt | Nurse Practitioner | 5805 Wild Orange Gate, Clarksville, MD 21029-1657 | 2020-08-18 |
| 1568087625 | Holly A Woosley | Nurse Practitioner | 746 W Kenwood Ave, Clarksville, IN 47129-2545 | 2020-06-14 |
| 1881222461 | Michelle G Rowan | Nurse Practitioner | 13515 Highland Rd, Clarksville, MD 21029-1427 | 2020-03-30 |
| 1669026258 | Ashley M Hettinger | Nurse Practitioner | 1455 Cedar St Ste D, Clarksville, IN 47129-7700 | 2019-07-31 |
| 1093375040 | Scarlett Hancock | Nurse Practitioner | 116 Commerce St, Clarksville, TN 37040-3641 | 2019-06-20 |
| 1336702067 | Leslea Renae Streetman | Nurse Practitioner | 525 Rosewood Dr, Clarksville, TN 37043-5126 | 2019-04-18 |
| 1629556980 | Julie Mcintosh | Nurse Practitioner | 1690 Fort Campbell Blvd, Clarksville, TN 37042-7531 | 2018-07-30 |
| 1720576218 | Chelsey Meek | Nurse Practitioner | 4101 Lena Ct, Clarksville, TN 37043-7625 | 2018-04-30 |
| 1316440696 | Kayla Vanden Hull | Nurse Practitioner | 3147 Cross Ridge Dr, Clarksville, TN 37040-5799 | 2018-03-13 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 37040 |
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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.