Provider Demographics
NPI:1003118019
Name:SCHAMP, STACY (CRNP)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:SCHAMP
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1297 MINERAL WELLS AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-5050
Mailing Address - Country:US
Mailing Address - Phone:731-227-6120
Mailing Address - Fax:731-227-6121
Practice Address - Street 1:1297 MINERAL WELLS AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5050
Practice Address - Country:US
Practice Address - Phone:731-227-6120
Practice Address - Fax:731-227-6121
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011093363LF0000X
TN34781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily