Doctor Name: | MRS. STACEY LEE MCDONALD |
NPI Number: | 1366867129 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, FNP-BC |
License Number: | 751210 |
Business Practice Address: | 1502 Meadow Ln Alvin, TX - 775113123 |
Business Phone Number: | 9792409110 |
Business Fax Number: | |
Mailing Address: | 104 7th St, BAY CITY |
State: | TX |
Postal Code: | 774144853 |
Phone Number: | 9792413308 |
Fax Number: | |
NPI Enumeration Date: | 03/03/2014 |
NPI Last Update Date: | 09/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 751210 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |