Provider Demographics
NPI:1306585302
Name:STEADMAN, MISTY DAWN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:DAWN
Last Name:STEADMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:DAWN
Other - Last Name:DELLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3531 BRIARCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-1609
Mailing Address - Country:US
Mailing Address - Phone:972-746-6634
Mailing Address - Fax:
Practice Address - Street 1:190 E STACY RD STE 1720
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8744
Practice Address - Country:US
Practice Address - Phone:972-746-6634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1077294363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care