PAMELA RENEE STACY (NPI# 1821367327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821367327 |
| Entity Type | Individual |
| Full Name | PAMELA RENEE STACY |
| Credential | ACNP |
| Practice Address |
520 Douglas Blvd Tyler TX 75702-8307 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9035931721 |
| Mailing Telephone | (903) 324-6450 |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2017-08-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
729458 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 293825001 | 05 | |
| TX | TRICARE | 75-2616977-118 | 01 |
| TX | BCBS | 867N10 | 01 |
| TX | TRICARE | 75-2616977-007 | 01 |
| TX | TRICARE | 75-2616977-066 | 01 |
| TX | TRICARE | 752616977042 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477521466 | Pamela Jean Stacy | Social Worker | 720 N Marr Rd, Columbus, IN 47201-6660 | 2006-03-08 |
| Street Address |
520 DOUGLAS BLVD |
| City | TYLER |
| State | TX |
| Zip Code | 75702-8307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831197342 | Jean Rene Yates-halbert | Physician Assistant | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2005-07-08 |
| 1316555220 | Sherry Mathew | Pharmacist | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2020-07-16 |
| 1407487549 | Rosie M Niebuhr | Social Worker | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2020-01-28 |
| 1366899288 | Jeta Laurie Bowman | Nurse Practitioner | 520 Douglas Blvd, Tyler, TX 75702 | 2016-05-20 |
| 1679944946 | Laura Beth Sheets | Nurse Practitioner | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2015-10-13 |
| 1134596554 | Barakha Yadav Silvia | Pharmacist | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2015-09-02 |
| 1184009565 | Alyssa Laurich | Pharmacist | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2015-07-27 |
| 1285030981 | Kerri Martin | Nurse Practitioner | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2014-11-07 |
| 1710395819 | Maria Diaz | Pharmacist | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2014-08-01 |
| 1487072120 | Katie Storrs | Physician Assistant | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2014-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568071116 | Carie Elise Bodnar | Nurse Practitioner | 910 E Houston St Ste 500, Tyler, TX 75702-8365 | 2020-07-29 |
| 1821461070 | Matthew Applegate | Nurse Practitioner | 700 Olympic Plaza Cir Ste 407, Tyler, TX 75701-1952 | 2015-11-10 |
| 1053401588 | Rebecca A Turner | Nurse Practitioner | 1133 Medical Drive, Tyler, TX 75701 | 2006-10-13 |
| 1225049083 | Alice Meredithe Nix | Nurse Practitioner | 1530 Ssw Loop 323, Suite 123, Tyler, TX 75701-2562 | 2006-08-10 |
| 1174130462 | Jessica Lemoine Phillips | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-09-30 |
| 1366051526 | Bessie Burchfield | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-07-23 |
| 1033739388 | Eric Bradley Vogt | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-04-16 |
| 1922641299 | Marcus Evans | Nurse Practitioner | 703 S Fleishel Ave, Tyler, TX 75701-2015 | 2019-10-19 |
| 1578105771 | Haley Renee Dias | Nurse Practitioner | 4111 University Blvd, Tyler, TX 75701-6623 | 2019-10-09 |
| 1346718939 | Amber Dionne Wood | Nurse Practitioner | 619 S Fleishel Ave Ste 100, Tyler, TX 75701-2004 | 2018-11-13 |
| Find all providers in TYLER | ||||
Please comment or provide details below to improve the information on PAMELA RENEE STACY.
| 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.