Individual
STACEY NIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
900 EARL FRYE BLVD, SUITE A, AMORY, MS 38821-5507
(662) 256-9331
(662) 256-9335
Mailing address
900 EARL FRYE BLVD, SUITE A, AMORY, MS 38821-5507
(662) 256-9331
(662) 256-9336
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R853221
MS
363LF0000X
Family Nurse Practitioner
R853221
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02370956
—
MS
Enumeration date
05/15/2008
Last updated
03/02/2010
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