Provider Demographics
NPI:1942417548
Name:POSTON, STACEY LYNN (RN, MSN, NP)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:LYNN
Last Name:POSTON
Suffix:
Gender:F
Credentials:RN, MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E CHEVY CHASE DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4152
Mailing Address - Country:US
Mailing Address - Phone:818-230-7778
Mailing Address - Fax:
Practice Address - Street 1:65 N MADISON AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2035
Practice Address - Country:US
Practice Address - Phone:626-432-1681
Practice Address - Fax:626-432-6869
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 470207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily