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General NPI Number Information
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NPI Number | 1831874809
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Entity Type | Individual
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Provider Name | STACIE ALISSA HAY DNP, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 2069 W CENTER ST
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City | BEEBE
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State | AR
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Zip | 72012-2544
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Country | US
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Telephone | 501-682-9212
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Fax |
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Provider Business Mailing Address
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Address Line | 1192 JACKSON 2
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City | BRADFORD
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State | AR
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Zip | 72020-9413
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Country | US
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Telephone | 870-217-2265
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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 | 224754
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License Number State | AR
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