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Individual
MATTHEW STACY
Active
Individual
MATTHEW STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
835430
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1112932
TX
Other
Enumeration date
03/03/2023
Last updated
04/04/2023
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