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General NPI Number Information
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NPI Number | 1295243590
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Entity Type | Individual
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Provider Name | STACIE LILLY APRN
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Gender | Female
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Dates
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Enumeration Date | 01/21/2018
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1500 SW 1ST AVE
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City | OCALA
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State | FL
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Zip | 34471-6516
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Country | US
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Telephone | 407-303-7283
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Fax | 407-303-0473
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Provider Business Mailing Address
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Address Line | 16975 SE 27TH PLACE RD
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City | OCKLAWAHA
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State | FL
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Zip | 32179-2323
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Country | US
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Telephone | 352-598-7662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 9278130
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9278130
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License Number State | FL
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