Active NPI
Stacey L George, APN
- Family Nurse Practitioner
- Jonesboro, AR
National Provider Identifier
1336335603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A03045
- Practice address
- 5197 Providence Cir
Jonesboro, AR 72404-7838 - Phone
- (870) 802-0686
- NPI assigned
- Sep 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A03045 | AR | Primary |
Addresses
Primary practice location
5197 Providence Cir
Jonesboro, AR 72404-7838
Mailing address
5197 Providence Cir
Jonesboro, AR 72404-7838
Phone (870) 802-0686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 165274758 | Medicaid | AR |
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 |
|---|---|---|---|
| A03045 | AR | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545177600000",
"number": "1336335603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5197 PROVIDENCE CIR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724047838",
"telephone_number": "870-802-0686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5197 PROVIDENCE CIR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724047838",
"telephone_number": "870-802-0686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "STACEY",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-20",
"last_updated": "2018-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A03045",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "165274758",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.