Provider Demographics
NPI:1639653884
Name:FLOWERS, STACY (FNP)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:SHEREE
Other - Last Name:TIPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1311 VIRGINIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-2536
Mailing Address - Country:US
Mailing Address - Phone:423-716-5412
Mailing Address - Fax:
Practice Address - Street 1:5616 BRAINERD RD STE 108
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5377
Practice Address - Country:US
Practice Address - Phone:423-803-1379
Practice Address - Fax:855-699-6867
Is Sole Proprietor?:No
Enumeration Date:2018-09-23
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000024455363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily