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Individual

STACEY L FAGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
52 UNDERWOOD ST, ORLANDO, FL 32806-1110
(888) 805-0085
(312) 863-7623
Mailing address
1 EMBARCADERO CTR STE 1900, SAN FRANCISCO, CA 94111-3723
(888) 663-6331

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
357616
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11044213
FL
363LF0000X
Family Nurse Practitioner
SP016266
PA

Other

Enumeration date
06/28/2016
Last updated
05/14/2026
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