STACY A MARTIN (NPI# 1174132435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174132435 |
| Entity Type | Individual |
| Full Name | STACY A MARTIN |
| Credential | APRN |
| Practice Address |
4896 Highway 90 Ste A Marianna FL 32446-7840 |
| Mailing Address |
4250 Hospital Dr Marianna FL 32446-1917 |
| Practice Telephone | 8505266700 |
| Practice Fax Number | 8505266701 |
| Mailing Telephone | 8507182531 |
| Mailing Fax Number | 8507182844 |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN11008224 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 107516500 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4296 5th Ave, Marianna, FL 324462173 | 8504822061 | 8506335911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932628385 | Stacy Martin | Counselor | Tuscarawas County Alcohol and Addiction Program, 897 E. Iron Ave., Dover, OH 44622 | 2017-09-18 |
| 1710403514 | Stacy L Martin | Student in an Organized Health Care Education/Training Program | 1500 S Avenue K # 3, Portales, NM 88130-7400 | 2017-08-14 |
| 1699143784 | Stacy Martin | Physical Therapy Assistant | 300 Strode Ave, Coatesville, PA 19320-2874 | 2015-09-08 |
| 1407239585 | Stacy Martin | Counselor | 3e Cleveland Ct, Greenville, SC 29607-2414 | 2015-07-07 |
| 1730512567 | Stacy Erin Martin | Counselor | 141 Loire Valley Dr, Pittsburgh, PA 15209-1070 | 2013-08-15 |
| 1013241264 | Stacy Martin | Counselor | 251 Fleet St, Rankin, PA 15104-1150 | 2009-09-21 |
| 1295987162 | Stacy A. Martin | Social Worker | 2005 Mclain St, Newport, AR 72112-3662 | 2008-10-22 |
| 1760688907 | Stacy Martin | Behavioral Analyst | 882 Eastchester Dr, Gahanna, OH 43230-5137 | 2007-06-25 |
| 1992763569 | Stacy D Martin | Nurse Practitioner | 1566 Pea Ridge Rd, Scottsville, KY 42164-7702 | 2006-05-03 |
| 1467950824 | Stacy Angela Martin | Case Manager/Care Coordinator | 1009 Maitland Center Commons Blvd Ste 212, Maitland, FL 32751-7270 | 2018-01-30 |
| Street Address |
4896 HIGHWAY 90 STE A |
| City | MARIANNA |
| State | FL |
| Zip Code | 32446-7840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851943542 | Anastasia Marie Horne | Nurse Practitioner | 4896 Highway 90 Ste A, Marianna, FL 32446-7840 | 2019-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962054817 | Covenant Home Health Care, LLC | Home Health | 4540 Lafayette Street, Ste. G, Marianna, FL 32446 | 2019-07-11 |
| 1063902930 | Syntha Alvarez | Assistant Behavior Analyst | 3217 Highway 71, Marianna, FL 32446 | 2018-05-15 |
| 1922528926 | Charlotte Allen | Respite Care | 4326 Deering Street, Marianna, FL 32446 | 2017-06-21 |
| 1003352097 | Jonathan Lee | Physical Therapist | 4387 Kelson Ave Apt A, Marianna, FL 32446 | 2017-01-13 |
| 1386003192 | Harold B Parker | Nurse Practitioner | Sunland Center 3700 Williams Drive, Marianna, FL 32446 | 2016-02-22 |
| 1912372756 | John Tyler Ellerbee | Nurse Practitioner | 4215 E Kelson Ave, Marianna, FL 32446 | 2015-12-04 |
| 1902206790 | Jason Williams | Spec/Tech, Cardiovascular | 3625 Fci Road, Marianna, FL 32446 | 2014-08-28 |
| 1336558238 | Rocky Mountain Holdings, LLC | Ambulance | 3689 Industrial Park Dr, Marianna, FL 32446 | 2014-08-05 |
| 1831430826 | Jantzen Wayne Whitehead | Counselor | 2860 Highway 71 N, Suite A, Marianna, FL 32446 | 2013-03-15 |
| 1336498047 | Sharon Lynn Miller | Counselor | 2933 Madison Street, Marianna, FL 32446 | 2012-09-10 |
| Find all providers in zip 32446 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851943542 | Anastasia Marie Horne | Nurse Practitioner | 4896 Highway 90 Ste A, Marianna, FL 32446-7840 | 2019-07-12 |
| 1629547641 | Julia Nichole Tice | Nurse Practitioner | 4215 Kelson Ave Ste E, Marianna, FL 32446-6555 | 2018-11-20 |
| 1487123428 | April Renee Cooper | Nurse Practitioner | 4230 Hospital Dr Ste 101, Marianna, FL 32446-1927 | 2018-11-20 |
| 1356885503 | Lisa Menchion | Nurse Practitioner | 3742b Skyview Rd, Marianna, FL 32446-8348 | 2016-12-07 |
| 1386003192 | Harold B Parker | Nurse Practitioner | Sunland Center 3700 Williams Drive, Marianna, FL 32446 | 2016-02-22 |
| 1548638869 | Nicole Hoff Green | Nurse Practitioner | 2989 Caledonia St, Marianna, FL 32446-3005 | 2015-09-02 |
| 1669650156 | Imani Carolyn Goodwin | Nurse Practitioner | 4680 Us Highway 90, Marianna, FL 32446 | 2008-02-06 |
| 1578525150 | Cynthia Jane Rudd | Nurse Practitioner | 4684 Highway 90, Marianna, FL 32446-3503 | 2006-04-06 |
| 1033765490 | Keisha A. Fox | Nurse Practitioner | 530 Atkins Blvd, Marianna, AR 72360-2198 | 2019-08-12 |
| 1043776180 | Kristie Bard | Nurse Practitioner | 4316 5th Ave, Marianna, FL 32446-2182 | 2019-02-13 |
| Find all providers in MARIANNA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.