Provider Demographics
NPI:1851467914
Name:STONE-DUFFY, MARY (ARNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:STONE-DUFFY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 45TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2402
Mailing Address - Country:US
Mailing Address - Phone:561-383-8000
Mailing Address - Fax:561-514-1275
Practice Address - Street 1:1041 45TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2402
Practice Address - Country:US
Practice Address - Phone:561-383-8000
Practice Address - Fax:561-514-1275
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1877622163WP0809X
FLARNP1877622163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP1877622OtherSTATE LICENSE NUMBER
FL767020600Medicaid