Individual
STACI MICHELLE MCKEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNS
Contact information
Practice address
3410 WORTH ST, SUITE 250, DALLAS, TX 75246-2003
(214) 820-6856
Mailing address
3410 WORTH ST, SUITE 250, DALLAS, TX 75246-2003
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
700711
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13218
RX AUTHORIZATION
TX
01
—
700711
RN LICENSE
TX
01
—
90194305
DPS
TX
01
—
AP122596
APRN LICENSE NUMBER
TX
Enumeration date
10/19/2012
Last updated
03/07/2023
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