Provider Demographics
NPI:1336861244
Name:CAREY, STACEY M (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:M
Last Name:CAREY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:STACEY
Other - Middle Name:M
Other - Last Name:HARNESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3800 ZUBER RD
Mailing Address - Street 2:
Mailing Address - City:ORIENT
Mailing Address - State:OH
Mailing Address - Zip Code:43146-9407
Mailing Address - Country:US
Mailing Address - Phone:614-323-2759
Mailing Address - Fax:
Practice Address - Street 1:1161 BETHEL RD STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2773
Practice Address - Country:US
Practice Address - Phone:614-459-0350
Practice Address - Fax:614-459-0355
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily