Stacy Christine Denisiuk, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28203249A Issued in IN

Practice address

1541 E Tipton St
Seymour, IN 47274-3557

Phone

(812) 522-8556

NPI assigned

Jul 14, 2017

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

• Stacy Eveslage Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: stacy.denisiuk.2@23284.direct.athenahealth.com

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499990400000",
    "number": "1669994265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 E TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472743557",
            "telephone_number": "812-522-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENISIUK",
        "first_name": "STACY",
        "middle_name": "CHRISTINE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28203249A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "EVESLAGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bethany Daugherty, MS, RDN, CD
• David E. Dollens, MD,LLC
• Jason Wayne Davis, MIP
• Victoria Deaton, RBT
• Ma Rosario S Dejesus
• Chance Densford, PHARMD
• Victoria R Denz-Wilson, DO
• Emilia M Diaz, PA
• Amanda Marie Dick, M.D.
• Andrew Edwin Dick, M.D.

• Family Nurse Practitioner in Seymour, IN
• Providers in Seymour, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; 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.