Provider Demographics
NPI:1578596755
Name:STUBBS, NANCY DANIELLE (FNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:DANIELLE
Last Name:STUBBS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:STUBBS
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:650 JOEL DR
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5318
Mailing Address - Country:US
Mailing Address - Phone:270-798-8727
Mailing Address - Fax:615-873-7881
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-412-9907
Practice Address - Fax:615-873-7881
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily