Stacey Bonecutter, FNP
Individual provider Active NPI Family Nurse Practitioner · Manistee, MI
NPI 1194139527 · NPPES record last updated Jul 19, 2016
Key facts
- NPI
- 1194139527
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704217372 (MI)
- Practice address
- 1806 E Parkdale Ave
Ste 3
Manistee, MI 49660-9364 - Phone
- (231) 398-9536
- Fax
- (231) 398-9541
- NPI assigned
- Jun 13, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33920 | TN | MD | Pharmacist |
Interoperability endpoints
- sbonecutter@wment.ssdirect.aprima.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704217372 | MI | Yes |
Addresses
Primary practice location
1806 E Parkdale Ave
Ste 3
Manistee, MI 49660-9364
Mailing address
1806 E Parkdale Ave
Ste 3
Manistee, MI 49660-9364
Phone (231) 398-9536
Other providers in Manistee, MI
- Blue Coast Vision PC
- Blythe a O'Donnell, PLLC
- Richard Artin Bobian
- Fritz R Boehm
- Heidi L Boehm
- Kenneth Albert Borenitsch
- April May Bovee
- Jaime L Boyer
- Summer L Brave Bull
- Brian J McComb DO PLLC
All providers in Manistee, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.