Stacey Ann Poole, DNP, RN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11012113 Issued in FL

Practice address

521 Risen Star Dr
Crestview, FL 32539-6071

Phone

(480) 608-5157

NPI assigned

May 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1366065104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 RISEN STAR DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325396071",
            "telephone_number": "480-808-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 RISEN STAR DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325396071",
            "telephone_number": "480-608-5157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Balcones Dr # Dr100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787314257",
            "country_code": "US",
            "telephone_number": "325-812-4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOLE",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "credential": "DNP, RN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9559718",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "245674",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP145602",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11012113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PHC-Crestview Inc
• Esther Mae Phelps, LMHC
• Pamela Pierce, LCSW
• Elizabeth Rita Pixley, MA, NCC, LMHC, LPC
• Isaac Henry Plummer Jr.
• Heather Powell, LCSW
• Suzie Ann Powers
• PPCC, Inc.
• Carrie Ellen Prescott
• Helen Ann Preston, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Crestview, FL
• Providers in Crestview, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.