Provider Demographics
NPI:1558073973
Name:CLOUD, STEPHANIE RACHELE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RACHELE
Last Name:CLOUD
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:RACHELE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8286 FIRE TOWER RD
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-8866
Mailing Address - Country:US
Mailing Address - Phone:409-659-2739
Mailing Address - Fax:
Practice Address - Street 1:810 HOSPITAL DR STE 320
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4655
Practice Address - Country:US
Practice Address - Phone:409-209-3083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1102088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily