Provider Demographics
NPI:1659002483
Name:SINGLETON, STACI ERIN
Entity Type:Individual
Prefix:MRS
First Name:STACI
Middle Name:ERIN
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MCKINNEY AVE APT 1907
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-1725
Mailing Address - Country:US
Mailing Address - Phone:214-228-7094
Mailing Address - Fax:
Practice Address - Street 1:7929 BROOKRIVER DR STE 180
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4920
Practice Address - Country:US
Practice Address - Phone:214-525-0681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX930697163WG0000X
TX1057299363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice