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General NPI Number Information
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NPI Number | 1487624607
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Entity Type | Individual
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Provider Name | STACY ANN NICHOLS-BYLL M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 6322 ARBOR DR
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City | SHREWSBURY
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State | MA
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Zip | 01545-6017
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Country | US
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Telephone | 830-399-5455
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Fax |
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Provider Business Mailing Address
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Address Line | 6322 ARBOR DR
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City | SHREWSBURY
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State | MA
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Zip | 01545-6017
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Country | US
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Telephone | 830-399-5455
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 04-34598
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 18698
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME111597
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD-41725
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2426
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License Number State | VI
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 21188
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License Number State | NE
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Taxonomy #7
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01049920A
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License Number State | IN
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Taxonomy #8
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 1020891
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License Number State | MA
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Taxonomy #9
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101245035
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License Number State | VA
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Taxonomy #10
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD2024-0675
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License Number State | NM
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