Kimberly Stacy, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L0065402 Issued in OK

Practice address

2325 S Harvard Ave
Tulsa, OK 74114-3300

Phone

(918) 712-4301

Fax

(918) 712-4309

NPI assigned

Oct 31, 2022

Last updated

Nov 3, 2022By the provider in NPPES

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

• Kim Hawkins 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": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1497462469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-712-4301",
            "fax_number": "918-712-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-712-4301",
            "fax_number": "918-712-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "KIMBERLY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "L0065402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "HAWKINS",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Larry Gene Stabler, MD
• Cory L Stacey, CRNA
• Lainey Hayes Stach
• Stacy Mitchell
• Cory Elizabeth Stacy
• Mark Stacy Jr.
• Mary Cassidy Stacy
• Stanley R Stacy, DO
• Jessica Kay Stadler, FNP-C
• John Kellen Stadler, DO

• Licensed Practical Nurse in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.