STEFANIE RENEE BRACKIN


Address: 4802 E Johnson Ave, Jonesboro, AR 72401-8413
Phone: 8709368000

STEFANIE RENEE BRACKIN (NPI# 1225512635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225512635
Entity Type Individual
Full Name STEFANIE RENEE BRACKIN
Other Name STEFANIE LONG
Credential APRN
Practice Address 4802 E Johnson Ave
Jonesboro
AR 72401-8413
Mailing Address Po Box 1960
Jonesboro
AR 72403-1960
Practice Telephone 8709368000
Practice Fax Number 8709343635
Mailing Telephone 8709368000
Mailing Fax Number 8709343635
Enumeration Date 2018-09-20
Last Update Date 2018-10-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
A005905 AR Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 4802 E JOHNSON AVE
City JONESBORO
State AR
Zip Code 72401-8413

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699779686 Paul S Levy Thoracic Surgery (Cardiothoracic Vascular Surgery) 4802 E Johnson Ave, Jonesboro, AR 72401 2005-06-08
1316546138 Emily M Allen Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2020-10-22
1699387274 Sarah E Dulaney Clinical Nurse Specialist 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2020-08-17
1154965036 Danny Lee Ricker Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-11-04
1679117659 Ryan Scott Anderson Clinical Nurse Specialist 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-11-01
1366086787 Jennifer L Turnbow Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-10-29
1487201703 Mary Daniel Johnson Dietitian, Registered 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-08-21
1285288357 Kellye P Brown Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-07-28
1801448592 Helen F Williams Nurse Practitioner 4802 E Johnson Ave, Jonesboro, AR 72405-8413 2019-07-12
1801350285 Brandy N Herrington Physician Assistant 4802 E Johnson Ave, Jonesboro, AR 72401-8413 2019-01-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407453368 Mariah Kay Jackson Physical Therapy Assistant Creative Kids Therapy, Jonesboro, AR 72401 2020-10-05
1821606005 Kafayat Folake Iyanda Specialist/Technologist 2105 East Aggie Rd, Jonesboro, AR 72401 2020-07-14
1053936310 Josh Roberts Physical Therapist 1010 South Main St, Jonesboro, AR 72401 2020-06-12
1003449687 Amy Mary Elizabeth Daughhetee Nurse Practitioner 225 East Washington Ave, Jonesboro, AR 72401 2020-02-21
1871126698 Sarah Lowtharp Clinical Nurse Specialist 225 East Washington Ave., Jonesboro, AR 72401 2020-02-20
1891335519 Mallori Miller Case Manager/Care Coordinator 837 Willett Rd, Jonesboro, AR 72401 2020-01-10
1265073704 Michael Bruce Collie Registered Nurse 837 Williett Road, Jonesboro, AR 72401 2019-10-07
1285283432 Jonesboro Ambulatory Surgery Center, LLC Clinic/Center 1710 Mayfield Dr, Jonesboro, AR 72401 2019-09-10
1841843943 Destinee Katrina Cole Specialist/Technologist 2015 Aggie Rd, Jonesboro, AR 72401 2019-07-18
1699250472 Jessica Marie Mcnatt Occupational Therapist 907 County Road 753, Jonesboro, AR 72401 2018-09-27
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457958233 Kaitlyn Soffray Simmons Nurse Practitioner 500 Kitchen St, Jonesboro, AR 72401-3135 2020-10-05
1407463938 Aleshia Williams Nurse Practitioner 5401 Clear Creek Ln, Jonesboro, AR 72404-7006 2020-09-29
1790397495 Kbsolutions and Behavioral Support Services, LLC Nurse Practitioner 7265 Mount Zion Blvd Ste 1, Jonesboro, GA 30236-2519 2020-08-24
1568080646 Maryam A Muhammad Nurse Practitioner 2388 Reeves Creek Rd, Jonesboro, GA 30236-7229 2020-07-06
1346864121 Joy Brew Nurse Practitioner 8399 Members Dr, Jonesboro, GA 30236-4271 2020-06-08
1053932806 Sabrina Nannettee Bowen Nurse Practitioner 5800 C W Post Rd, Jonesboro, AR 72401-9602 2020-05-04
1265993182 Sara Ruth Johnson Nurse Practitioner 701 Windover Rd Ste 400, Jonesboro, AR 72401-6065 2019-03-26
1366927956 Yolanda Louise Davis Nurse Practitioner 1706 Heather Ridge Dr, Jonesboro, AR 72401-3748 2018-09-28
1457867475 Eucharia Udoka Obi Nurse Practitioner 9051 Jenni Cir, Jonesboro, GA 30238-6800 2017-12-28
1346752151 Chanel Dominque Bullock Nurse Practitioner 1150 E Matthews Ave Ste 203, Jonesboro, AR 72401 2017-11-02
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Competitor

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City JONESBORO
Zip Code 72401

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Dataset Information

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.

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