Provider Demographics
NPI:1073022885
Name:SEITZ, STACEY JO (FNP)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:JO
Last Name:SEITZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:J
Other - Last Name:SEITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CHMIEL
Mailing Address - Street 1:1750 17TH ST STE N
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-8690
Mailing Address - Country:US
Mailing Address - Phone:941-529-0200
Mailing Address - Fax:
Practice Address - Street 1:2350 SCENIC DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1510
Practice Address - Country:US
Practice Address - Phone:941-529-0200
Practice Address - Fax:941-475-9860
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9380324363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily