National Provider Identifier
Stacie Phan, RN
Stacie Phan, RN is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Rochester, NY and a listed phone number of (585) 244-1000.
Profile Overview
- NPI
- 1538605050
- Provider Type
- Individual
- Primary Specialty
- Family Nurse Practitioner
- Enumeration Date
- January 07, 2017
- Last Updated
- August 26, 2024
Practice Location
- 973 East Ave
- Rochester, NY 14607-2216
Phone: (585) 244-1000
Mailing Address
- 65 Oxford St
- Rochester, NY 14607-1507
Specialties
- Family Nurse Practitioner (363LF0000X)
- Medical-Surgical Registered Nurse (163WM0705X)
Full Record
- NPI
- 1538605050
- Entity Type
- Individual
- Last Name
- Phan
- First Name
- Stacie
- Credential
- RN
- Mailing Street Address
- 65 Oxford St
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14607-1507
- Mailing Country
- US
- Practice Street Address
- 973 East Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14607-2216
- Practice Country
- US
- Practice Phone
- (585) 244-1000
- Enumeration Date
- January 07, 2017
- Last Updated
- August 26, 2024
- Deactivation Date
- February 14, 2020
- Reactivation Date
- July 12, 2021
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- August 26, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Nurse Practitioner (363LF0000X), Medical-Surgical Registered Nurse (163WM0705X)