Individual
JOAN E STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1108 LAVACA ST STE 110-320, AUSTIN, TX 78701-2172
(512) 477-4088
Mailing address
1108 LAVACA ST, AUSTIN, TX 78701-2172
(512) 477-4088
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP138688
TX
363LG0600X
Gerontology Nurse Practitioner
AP138688
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558789487
—
NC
05
—
NP2777
—
SC
Enumeration date
03/28/2014
Last updated
05/16/2025
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