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Individual
MISS STACY KAY WHITEHEAD
Active
Individual
MISS STACY KAY WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10659
WI
363LF0000X
Family Nurse Practitioner
17937
TN
363LF0000X
Family Nurse Practitioner
218472
GA
363LF0000X
Family Nurse Practitioner
RN218472
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003158725D
—
GA
Enumeration date
09/25/2013
Last updated
11/30/2021
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