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Individual

STACEY L MCDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
5 MOBILE INFIRMARY CIR, MOBILE, AL 36607-3513
(251) 435-2646
Mailing address
PO BOX 10583, BIRMINGHAM, AL 35202-0583

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-108166
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141468
AL
01
511-28741
BCBS
AL
Enumeration date
07/30/2012
Last updated
01/10/2013
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