Provider Demographics
NPI:1821669144
Name:RAILSBACK, STACEY (CRNA)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:RAILSBACK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 GAP CREEK RD APT E
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-8559
Mailing Address - Country:US
Mailing Address - Phone:941-773-9334
Mailing Address - Fax:
Practice Address - Street 1:28 SCHENCK PKWY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-5053
Practice Address - Country:US
Practice Address - Phone:828-727-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC281979163WC0200X
NC139721367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine