Stacie McDonough, CRNP

Primary specialty

Neonatal Clinical Nurse SpecialistTaxonomy code 364SN0000X

License

26NJ00117000 Issued in NJ

Practice address

100 Madison Ave.
Morristown, NJ 07960

Phone

(973) 971-5488

Fax

(973) 290-7175

NPI assigned

Jun 27, 2018

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

Other names 1

• Stacie Boran Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1255826723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 EAST HANOVER AVE.",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "07927",
            "telephone_number": "973-605-8056",
            "fax_number": "973-605-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE.",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "07960",
            "telephone_number": "973-971-5488",
            "fax_number": "973-290-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "STACIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SN0000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Neonatal",
            "state": "NJ",
            "license": "26NJ00117000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "BORAN",
            "credential": "BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen McCormack
• Barbara McDevitt, MD
• Jody McDonald, LPC
• Kruti McDonald, PA
• Thomas McDonnell, MD, MPH
• Jenna A McGarry
• Sean Thomas McGurn, PA-C
• Phoebe Claire McKee, CNM
• Wendy Anderson McKenna, LCSW
• Mariah McKevitt, MD

• Clinical Nurse Specialist in Morristown, NJ
• Providers in Morristown, NJ by specialty
• Clinical Nurse Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.