Provider Demographics
NPI:1356722516
Name:BASINGER, STACY NICHOLE (NNP-BC)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:NICHOLE
Last Name:BASINGER
Suffix:
Gender:
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 COUNTY ROAD 677
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-9096
Mailing Address - Country:US
Mailing Address - Phone:256-338-1495
Mailing Address - Fax:
Practice Address - Street 1:450 COUNTY ROAD 677
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-9096
Practice Address - Country:US
Practice Address - Phone:256-338-1495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-119318363LN0005X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care