STACY ELLETT (NPI# 1245542786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245542786 |
| Entity Type | Individual |
| Full Name | STACY ELLETT |
| Credential | LPN |
| Practice Address |
323 Church Ave Ne Jacksonville AL 36265-1868 |
| Practice Telephone | 2563652374 |
| Mailing Telephone | 2563652374 |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 2037893 | AL | Nursing Service Providers |
| Street Address |
323 CHURCH AVE NE |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265-1868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443207 | Cheryl Elaine Dowdell | Licensed Practical Nurse | 1685 Biscayne Bay Cir, Jacksonville, FL 32218-8671 | 2020-09-24 |
| 1255959474 | Tracey Fitzgerald | Licensed Practical Nurse | 50 N Laura St Ste 2560, Jacksonville, FL 32202-3664 | 2020-07-14 |
| 1295350015 | Derekia Johnson | Licensed Practical Nurse | 8278 Golden Bamboo Dr, Jacksonville, FL 32219-6012 | 2020-06-08 |
| 1265052930 | Cristal Lashonda Daniels | Licensed Practical Nurse | 873 Plumbridge Ct, Jacksonville, FL 32218-6138 | 2020-04-22 |
| 1750917001 | Stacy Patreace Godwin | Licensed Practical Nurse | 7082 Saint Ives Ct, Jacksonville, FL 32244-0300 | 2020-03-19 |
| 1063045433 | Brenda Cherry | Licensed Practical Nurse | 12281 Drift Ct, Jacksonville, FL 32218-0841 | 2020-02-13 |
| 1598396046 | Jennifer Michelle Price | Licensed Practical Nurse | 2400 West Main, Jacksonville, AR 72076 | 2020-02-03 |
| 1619507936 | Cherika Philo | Licensed Practical Nurse | 4320 Sunbeam Rd Apt 219, Jacksonville, FL 32257-8828 | 2020-01-26 |
| 1467013805 | April Yolande Pollard | Licensed Practical Nurse | 1861 Boston Commons Way, Jacksonville, FL 32221-2131 | 2019-06-26 |
| 1184285652 | Cierra Elizabeth Carter | Licensed Practical Nurse | 906 W Monroe St Apt 401, Jacksonville, FL 32204-1184 | 2019-06-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
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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.