Provider Demographics
NPI:1841757150
Name:SMITH, STANCEY JANE (CRNP)
Entity Type:Individual
Prefix:
First Name:STANCEY
Middle Name:JANE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 TUSCALOOSA AVE SW
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1948
Mailing Address - Country:US
Mailing Address - Phone:205-679-6325
Mailing Address - Fax:205-783-8600
Practice Address - Street 1:1308 TUSCALOOSA AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1948
Practice Address - Country:US
Practice Address - Phone:205-679-6325
Practice Address - Fax:205-783-8600
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-163529163WX0003X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient