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Individual

STACY ANNE BRUEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AG-ACNP BC

Contact information

Practice address
1819 CLINCH AVE STE 110, KNOXVILLE, TN 37916-2435
(865) 331-9075
Mailing address
1819 CLINCH AVE STE 110, KNOXVILLE, TN 37916-2435
(865) 331-9075

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
265588
TN
163W00000X
Registered Nurse
RN446844
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
32326
TN
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.0029359
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q078565
TN
Enumeration date
08/03/2021
Last updated
04/27/2023
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