Provider Demographics
NPI:1982230223
Name:HARRINGTON, STACI URBANOSKY (FNP-C)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:URBANOSKY
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 674098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4098
Mailing Address - Country:US
Mailing Address - Phone:979-774-4008
Mailing Address - Fax:
Practice Address - Street 1:2700 E 29TH ST STE 220
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2586
Practice Address - Country:US
Practice Address - Phone:979-774-4008
Practice Address - Fax:979-731-8418
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily