Nelson, Stacey

Nelson, Stacey is an individual health care provider with primary practice located at 1704 E Broadway Ave , Maryville TN 37804. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Nelson, Stacey can be contacted via phone (865) 681-6990.

Contact Information

Primary practice address
1704 E Broadway Ave Maryville TN 37804
Phone: (865) 681-6990
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN0000175851 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APN22481 Tennessee

Profile Details

NPI number 1770839029
LBN Legal business name Nelson, Stacey
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2012
Last updated Apr 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770839029 NPPES
Tennessee MEDICAID Q027970

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