Provider Demographics
NPI:1871250951
Name:FIELDS, STACEY LYNNE (RN)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:LYNNE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HARWICH ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-1722
Mailing Address - Country:US
Mailing Address - Phone:203-988-5736
Mailing Address - Fax:
Practice Address - Street 1:38 TALMADGE AVE
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-3541
Practice Address - Country:US
Practice Address - Phone:203-988-5736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT143249163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control