Stacey L Wilson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP3315182 Issued in FL

Practice address

83 W Miller St
Orlando, FL 32806-2031

Phone

(321) 843-9792

NPI assigned

Jun 13, 2006

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

• Stacey L Kornbrust Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Apollo Medical Group of Ocala LLC

  • Anesthesiology Physician
  • Ocala, FL
  • NPI 1477326908

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• US Anesthesia Partners of Florida Inc.

  • Anesthesiology Physician
  • Maitland, FL
  • NPI 1518910520

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1861435331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 E CONCORD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035453",
            "telephone_number": "407-896-9500",
            "fax_number": "407-896-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062031",
            "telephone_number": "321-843-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3315182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "KORNBRUST",
            "middle_name": "L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole Wilson
• Nicole Claire Wilson, MD
• Rachel Elizabeth Wilson, M.D.
• Shayla Wilson
• Shinobu Wilson, BCBA
• Thomas W Wilson, LCSW
• Tito Wilson
• Trevelyn Wilson, RRA
• Valeska Lei-Lana Wilson, M.A., LMHC
• Leah Clare Wimberly, LCSW

• Certified Registered Nurse Anesthetist in Orlando, FL
• Providers in Orlando, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.