Healthcare Provider Details

I. General information

NPI: 1790736221
Provider Name (Legal Business Name): STACY RENEE RAMEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 N WESTMONTE DR SUITE 1005
ALTAMONTE SPRINGS FL
32714-3338
US

IV. Provider business mailing address

10051 5TH ST N SUITE 200
ST PETERSBURG FL
33702-2289
US

V. Phone/Fax

Practice location:
  • Phone: 321-397-7800
  • Fax: 813-514-8891
Mailing address:
  • Phone:
  • Fax: 813-514-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3005578
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberARNP9229076
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: