Provider Demographics
NPI:1366010290
Name:REEL, STACY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:REEL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 HARPER LN
Mailing Address - Street 2:
Mailing Address - City:ROYSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30662-2237
Mailing Address - Country:US
Mailing Address - Phone:706-599-2008
Mailing Address - Fax:
Practice Address - Street 1:819 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ROYSTON
Practice Address - State:GA
Practice Address - Zip Code:30662-4434
Practice Address - Country:US
Practice Address - Phone:706-245-6177
Practice Address - Fax:706-245-6242
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN241642363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily