Provider Demographics
NPI:1366867129
Name:MCDONALD, STACEY LEE (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:LEE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:LEE
Other - Last Name:LINNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:104 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-4853
Mailing Address - Country:US
Mailing Address - Phone:979-241-3308
Mailing Address - Fax:
Practice Address - Street 1:1502 MEADOW LN
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-3123
Practice Address - Country:US
Practice Address - Phone:979-240-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX751210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily