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NPI Code Detail

MEDICARE: MRS. STACEY CRYSTAL POMPA FNP-C

MEDICARE: MRS. STACEY CRYSTAL POMPA FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP134546TX

General Provider Information

NPI Number : 1285157495
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STACEY CRYSTAL POMPA FNP-C
Provider Business Mailing Address
First Line : 6110 STRASBOURG DR
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78414-6123
Country : US
Telephone Number : 361-742-1487
Fax Number :
Provider Business Practice Location Address
First Line : 3829 SARATOGA BLVD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78415-5814
Country : US
Telephone Number : 361-906-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2017
Last Update Date : 07/19/2017

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Directions to “ MRS. STACEY CRYSTAL POMPA FNP-C” Practice Location

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