Provider Demographics
NPI:1316064199
Name:STUBBS, NANCY K (APRN)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:K
Last Name:STUBBS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7917 MINERAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:MO
Mailing Address - Zip Code:65483-1388
Mailing Address - Country:US
Mailing Address - Phone:417-967-0057
Mailing Address - Fax:
Practice Address - Street 1:1100 N INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MO
Practice Address - Zip Code:65483-9407
Practice Address - Country:US
Practice Address - Phone:417-260-5519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO067986364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology