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General NPI Number Information
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NPI Number | 1528514528
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Entity Type | Individual
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Provider Name | STACY YANCEY CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 401 FERNDALE BLVD
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City | HIGH POINT
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State | NC
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Zip | 27262-4739
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Country | US
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Telephone | 336-882-2567
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Fax |
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Provider Business Mailing Address
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Address Line | 3979 NAVY PL
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City | HIGH POINT
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State | NC
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Zip | 27265-9443
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Country | US
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Telephone | 336-870-3484
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 113039
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 245610
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License Number State | NC
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