STACEY HUBBARD (NPI# 1811379639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811379639 |
| Entity Type | Individual |
| Full Name | STACEY HUBBARD |
| Credential | FNP |
| Practice Address |
119 Boone Ridge Dr Suite 201 Johnson City TN 37615-4998 |
| Practice Telephone | 8656736741 |
| Practice Fax Number | 8656736634 |
| Mailing Telephone | 8656736741 |
| Mailing Fax Number | 8656736634 |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2016-09-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R862145 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497151286 | Stacey T Hubbard | Counselor | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2014-11-06 |
| Street Address |
119 BOONE RIDGE DR SUITE 201 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37615-4998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639161722 | Melissa Dawn Venoy | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2005-08-16 |
| 1083157788 | Amy Hamilton | Nurse Practitioner | 119 Boone Ridge Dr, Ste 201, Johnson City, TN 37615-8000 | 2016-11-29 |
| 1366992851 | Nikki Daniell Vaughn | Registered Nurse | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-10-07 |
| 1790230183 | Laura Casey | Registered Nurse | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-08-16 |
| 1104277656 | Ipc Pac Healthcare Services of Tennessee PC | Psychologist | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-06-27 |
| 1487008835 | Amanda Milan Smith | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-04-21 |
| 1083084560 | Hannah Audia | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2015-09-28 |
| 1033593223 | Carleen Marie Ogle | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2015-07-17 |
| 1104209675 | Lindsey Townsend Elswick | Nurse Practitioner | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2015-07-02 |
| 1689077810 | Kayla Leann Taylor | Emergency Medicine | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2014-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025724 | Victoria Elizabeth Mcmanus | Nurse Practitioner | 365 Harry L Dr Ste 110, Johnson City, NY 13790-1471 | 2020-08-24 |
| 1649880139 | Amanda Danielle Ledford | Nurse Practitioner | 3 Enfield Ct, Johnson City, TN 37604-9101 | 2020-08-09 |
| 1861000135 | Deborah L Johnson | Nurse Practitioner | 2 Mcgregor Pl, Johnson City, TN 37604-1454 | 2020-07-22 |
| 1255978417 | William Mcguire | Nurse Practitioner | 176 Willocks Rd, Johnson City, TN 37601-6274 | 2019-12-06 |
| 1881248664 | Caiti Riden | Nurse Practitioner | 316 Marketplace Dr Ste 10, Johnson City, TN 37604-2595 | 2019-07-30 |
| 1699330282 | Courtney S Willis | Nurse Practitioner | 2203 N Greenwood Dr, Johnson City, TN 37604-7030 | 2019-05-08 |
| 1861955452 | Cindy Canter | Nurse Practitioner | 3552 Greenwood Dr, Johnson City, TN 37604-2834 | 2019-04-10 |
| 1366908980 | Holly Anne Parvin | Nurse Practitioner | 3209 W Walnut St, Johnson City, TN 37604-5949 | 2019-02-19 |
| 1891261376 | Lindsey Toney | Nurse Practitioner | 980 Smalling Rd, Johnson City, TN 37601-8208 | 2018-10-22 |
| 1821572868 | Karyn Kimberly Bruton | Nurse Practitioner | 1723 N Roan St, Johnson City, TN 37601-3949 | 2018-09-15 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37615 |
Please comment or provide details below to improve the information on STACEY HUBBARD.
| 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.