Active NPI
Staci Gaudin
- Licensed Practical Nurse
- Wesley Chapel, FL
National Provider Identifier
1073103230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN938301
- Practice address
- 26313 Limestone Springs Way
Wesley Chapel, FL 33544-6712 - Phone
- (813) 309-8886
- NPI assigned
- Jan 21, 2021
- Last updated
- Jan 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN938301 | FL | Primary |
Addresses
Primary practice location
26313 Limestone Springs Way
Wesley Chapel, FL 33544-6712
Mailing address
805 N Whittington Pkwy
Louisville, KY 40222-7101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN938301 | FL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1073103230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 N WHITTINGTON PKWY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402227101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26313 LIMESTONE SPRINGS WAY",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335446712",
"telephone_number": "813-309-8886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDIN",
"first_name": "STACI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN938301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wesley Chapel, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.