Provider Demographics
NPI:1508115478
Name:SPRIGGS, STACEY B (RN)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:B
Last Name:SPRIGGS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 N DRUID HILLS RD
Mailing Address - Street 2:#P
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3720
Mailing Address - Country:US
Mailing Address - Phone:678-887-9889
Mailing Address - Fax:
Practice Address - Street 1:4151 MEMORIAL DR
Practice Address - Street 2:SUITE 209C
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-1504
Practice Address - Country:US
Practice Address - Phone:404-508-0078
Practice Address - Fax:404-508-0071
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN142075163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse