Healthcare Provider Details

I. General information

NPI: 1518128230
Provider Name (Legal Business Name): STACEY ANN GERARDI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACEY ANN FRANCESS

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 11/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 SE OSCEOLA ST SUITE 3
STUART FL
34994-2505
US

IV. Provider business mailing address

2508 SW CAMEO BLVD
PORT SAINT LUCIE FL
34953-2930
US

V. Phone/Fax

Practice location:
  • Phone: 772-286-0338
  • Fax: 772-287-1139
Mailing address:
  • Phone: 772-785-9803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberANT2729002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: