Individual
TARA MARIE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1360 DOLLY PARTON PKWY, SEVIERVILLE, TN 37862-3715
(865) 429-0921
Mailing address
324 BELMONT DR, BRISTOL, TN 37620-4926
(423) 646-0002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN0000026102
TN
Other
Enumeration date
10/06/2019
Last updated
10/06/2019
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