Provider Demographics
NPI:1033710371
Name:JONES, STACY (APRN)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18550 US HIGHWAY 441
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6751
Mailing Address - Country:US
Mailing Address - Phone:352-735-3755
Mailing Address - Fax:352-735-3151
Practice Address - Street 1:18550 US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6751
Practice Address - Country:US
Practice Address - Phone:352-735-3755
Practice Address - Fax:352-735-3151
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010448363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care