Stacy Gardner

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

STACY GARDNER

Doing business as

Professional Health Services

Practice address

410 W Saint Louis St
West Frankfort, IL 62896-1956

Phone

(618) 932-2200

Fax

(618) 932-2202

NPI assigned

Mar 27, 2008

Last updated

Aug 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stacy Gardner, FNP-BC

Title

Family Nurse Practitioner/ Owner

Phone

(618) 932-2200

Specialties & licenses 2

Addresses

Other names 1

• Professional Health Services Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacy D Menees, FNP

  • Family Nurse Practitioner
  • Centralia, IL
  • NPI 1386815959
  NPD (past)

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250467200000",
    "number": "1285806422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W SAINT LOUIS ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628961956",
            "telephone_number": "618-932-2200",
            "fax_number": "618-932-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W SAINT LOUIS ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628961956",
            "telephone_number": "618-932-2200",
            "fax_number": "618-932-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY GARDNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2009-08-17",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER/ OWNER",
        "authorized_official_telephone_number": "618-932-2200",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IL",
            "license": "209007026",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sue C Speers
• Marie A Spelich
• Spero Family Services
• Stacey A Springer
• Amy Stacey, PA
• Tonya Steele, LPN
• Stephen L Ponton DPM
• Jennifer L Stowers
• Lisa R Stritzel
• Wesley Summers

• Family Nurse Practitioner in West Frankfort, IL
• Providers in West Frankfort, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; 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.