Individual
STACIA INNAMORATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-APRN
Contact information
Practice address
1004 W 1ST ST, BLOOMINGTON, IN 47403-2208
(812) 362-5149
Mailing address
1004 W 1ST ST, BLOOMINGTON, IN 47403-2208
(812) 362-5149
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28148134C
IN
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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