Amanda Kellie Stegall, ACNPC-AG

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

906411 Issued in MS

Practice address

971 Lakeland Dr Ste 1250
Jackson, MS 39216-4609

Phone

(601) 200-2990

Fax

(601) 200-5939

NPI assigned

Jan 1, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1083483085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "601-200-2990",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 1250",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164609",
            "telephone_number": "601-200-2990",
            "fax_number": "601-200-5939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "969 Lakeland Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164699",
            "country_code": "US",
            "telephone_number": "601-200-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEGALL",
        "first_name": "AMANDA",
        "middle_name": "KELLIE",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-01",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "906411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Statham, DO
• Amanda Stauble, APRN
• Denisse Leticia Staufert Gutierrez, MD
• Michelle Steadman
• Josephine Cenzalli Steevens, PHARM.D.
• Jacob Michael Steiniger
• Step Up Counseling & Consulting
• Kendra Stephen
• Christopher L Stephens, CRNA
• Jeffrey Cole Stephens

• Acute Care Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Acute Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.