Provider Demographics
NPI:1265515340
Name:JAMES, STACY HEALY (RN, MSN, ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:HEALY
Last Name:JAMES
Suffix:
Gender:F
Credentials:RN, MSN, ACNP-BC
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:ANN
Other - Last Name:HEALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:536 WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-1239
Mailing Address - Country:US
Mailing Address - Phone:707-257-7330
Mailing Address - Fax:
Practice Address - Street 1:1000 TRANCAS ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2906
Practice Address - Country:US
Practice Address - Phone:707-252-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP15789363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA129730OtherMEDICARE PTAN