Provider Demographics
NPI:1760248579
Name:MCFARLANE, STACY DAWN (APRN)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:DAWN
Last Name:MCFARLANE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8114 N GIRARD CIR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-2605
Mailing Address - Country:US
Mailing Address - Phone:208-770-8149
Mailing Address - Fax:
Practice Address - Street 1:8114 N GIRARD CIR
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-2605
Practice Address - Country:US
Practice Address - Phone:208-770-8149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID70565363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner