Individual
STACIE G CARLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, NNP-BC
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(036) 061-7219
Mailing address
3213 SUNSET DR, SAN ANGELO, TX 76904-6042
(575) 200-5424
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
1205776
TX
Other
Enumeration date
05/13/2025
Last updated
07/25/2025
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