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General NPI Number Information
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NPI Number | 1558007146
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Entity Type | Individual
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Provider Name | STACEY WALL ROKAS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/07/2022
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 7735 FARMINGTON BLVD
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City | GERMANTOWN
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State | TN
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Zip | 38138-2901
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Country | US
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Telephone | 256-529-5260
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 32082
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F04220419
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License Number State | TN
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