Physician Compare National (NPI:1922358027)

HEALTHCARE PROVIDER: STACEY LORRIANE FEARS NP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1922358027
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385896653
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121212000602
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FEARS
	Individual professional last name
Provider First Name	STACEY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3790 PLEASANT HILL RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 260
	Group Practice or individual's line 2 address
City	DULUTH
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	300965147
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y