Individual
MRS. STACEY L GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5197 PROVIDENCE CIR, JONESBORO, AR 72404-7838
(870) 802-0686
Mailing address
5197 PROVIDENCE CIR, JONESBORO, AR 72404-7838
(870) 802-0686
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A03045
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165274758
—
AR
Enumeration date
09/20/2007
Last updated
12/19/2018
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