STACY CREEL (NPI# 1679956056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679956056 |
| Entity Type | Individual |
| Full Name | STACY CREEL |
| Practice Address |
6602 Waters Ave Bldg C Savannah GA 31406-2778 |
| Practice Telephone | 9123547676 |
| Practice Fax Number | 9123546040 |
| Mailing Telephone | 9123547676 |
| Mailing Fax Number | 9123546040 |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2019-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN221254 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6602 WATERS AVE BLDG C |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31406-2778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669580262 | Wallette Gwen Widener | Nurse Practitioner | 6602 Waters Ave Bldg C, Savannah, GA 31406-2716 | 2006-08-25 |
| 1689209819 | Amanda Methe Lilienthal | Nurse Practitioner | 6602 Waters Ave Bldg C, Savannah, GA 31406-2778 | 2020-03-09 |
| 1295272714 | Shelby Elizabeth Calloway | Nurse Practitioner | 6602 Waters Ave Bldg C, Savannah, GA 31406 | 2017-01-22 |
| 1003279258 | Caroline Shealy Sauers | Nurse Practitioner | 6602 Waters Ave Bldg C, Savannah, GA 31406-2778 | 2016-04-04 |
| 1891169827 | Doungphon Vongsaona Nelson | Nurse Practitioner | 6602 Waters Ave Bldg C, Savannah, GA 31406-2778 | 2015-11-13 |
| 1164746624 | Stephen N Donahue | Psychiatry & Neurology | 6602 Waters Ave Bldg C, Savannah, GA 31406-2778 | 2010-03-26 |
| 1679801534 | Amanda Lynn Merritt | Nurse Practitioner | 6602 Waters Ave Bldg C, Savannah, GA 31406-2778 | 2009-12-03 |
| 1023285319 | Angie Ray Moye | Nurse Practitioner | 6602 Waters Ave Bldg C, Savannah, GA 31406-2778 | 2008-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324042 | Magnolia Home Health, LLC Dba Home Instead Senior Care | Homemaker | 6709 Forest Park Drive, Suite B, Savannah, GA 31406 | 2020-04-08 |
| 1831737949 | Sumona Mitchell | Specialist | 1100 Eisenhower Drive 15, Suite 7, Savannah, GA 31406 | 2019-12-19 |
| 1295373090 | Gateway Behavioral Health Services | Community/Behavioral Health | 2121 East Derenne Ave, Savannah, GA 31406 | 2019-12-12 |
| 1114578820 | Kenya Burns | Technician | 6 Castle Ct, Savannah, GA 31406 | 2019-09-24 |
| 1841755287 | Southside Emergency Dental Center LLC | Dentist | 10515 White Bluff Rd., Savannah, GA 31406 | 2019-02-08 |
| 1639651003 | Rachael Putman | Physical Therapist | 37 W Fairmont Ave Suite 323, Savannah, GA 31406 | 2018-09-03 |
| 1417439852 | Happy Kids Therapies, LLC | Physical Therapist | 37 W. Fairmont Avenue Suite 102, Savannah, GA 31406 | 2018-09-01 |
| 1487146619 | Georgia Occmed LLC | Clinic/Center | 310 Eisenhower Dr Bldg 12 Ste C, Savannah, GA 31406 | 2018-06-04 |
| 1023517505 | Antioch Vascular Center, LLC | Surgery | 9104 Middleground Road, Suite 2, Savannah, GA 31406 | 2018-02-09 |
| 1518496116 | Janay C Russell | Counselor | 6711 Forest Park Drive, Savannah, GA 31406 | 2017-06-07 |
| Find all providers in zip 31406 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811682 | Ashlee Renee Mack | Nurse Practitioner | 116 Slate Cir, Savannah, GA 31419-9681 | 2020-08-16 |
| 1861038044 | Mara Dawne Carson | Nurse Practitioner | 1515 Benton Blvd Apt 1328, Savannah, GA 31407-0440 | 2019-11-21 |
| 1710534474 | Aaron Montover | Nurse Practitioner | 225 Candler Dr Ste 301, Savannah, GA 31405-6091 | 2019-08-19 |
| 1407227994 | James Doyle Herring IIi | Nurse Practitioner | 302 Surrey Rd, Savannah, GA 31410-4407 | 2015-10-09 |
| 1649646688 | Susan Ahle | Nurse Practitioner | 8 Dockside Dr, Savannah, GA 31410-2536 | 2015-08-13 |
| 1912554841 | Haley Brooke Mccain | Nurse Practitioner | 1326 Eisenhower Dr Bldg 2, Savannah, GA 31406-3928 | 2019-08-26 |
| 1356993679 | Lana Marie Stark | Nurse Practitioner | 107 Southern Blvd, Savannah, GA 31405-7437 | 2019-07-16 |
| 1700308509 | Tiffany Lee Boulanger | Nurse Practitioner | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2017-07-13 |
| 1205383130 | Beverly J Lippert | Nurse Practitioner | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2016-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032114 | Candace Buckley | Nurse Practitioner | 244 Ashland Dr, Woodstock, GA 30189-7161 | 2020-10-29 |
| 1679170740 | Jennifer Lassiter | Nurse Practitioner | 4116 Holley Rd., Lizella, GA 31052 | 2020-10-02 |
| 1891301164 | Tashoy Wallace | Nurse Practitioner | 121 Odyssey Turn, Conyers, GA 30012-3681 | 2020-09-21 |
| 1912513672 | Katherine Anne Sego | Nurse Practitioner | 4060 Rolling Meadows Ln, Watkinsville, GA 30677-3011 | 2020-09-18 |
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1588276505 | Sherron Johnson | Nurse Practitioner | 1980 Wrights Way, Jonesboro, GA 30236-7205 | 2020-08-20 |
| 1467063610 | Rosa Maria Phillips | Nurse Practitioner | 649 Amicalola Woods Rd, Dawsonville, GA 30534-1205 | 2020-08-12 |
| 1508476581 | Jarvis Reese | Nurse Practitioner | 413 Tug Ct, Warner Robins, GA 31088-2134 | 2020-08-05 |
| 1750991790 | Akosua Frema Sarfo | Nurse Practitioner | 116 Ginkgo Ln, Grovetown, GA 30813-5392 | 2020-08-04 |
| 1851919039 | Robert Brant | Nurse Practitioner | 20 Fairway Oaks, Waverly, GA 31565-2767 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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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.