Provider Demographics
NPI:1881378891
Name:DAVEY, STACY PENNINGTON (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:PENNINGTON
Last Name:DAVEY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7845 W RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5515
Mailing Address - Country:US
Mailing Address - Phone:440-481-1615
Mailing Address - Fax:
Practice Address - Street 1:7845 W RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5515
Practice Address - Country:US
Practice Address - Phone:440-481-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0033754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily