Provider Demographics
NPI:1699082677
Name:CALES, STACY (MSN, RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:CALES
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 SUMMERS ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-6022
Mailing Address - Country:US
Mailing Address - Phone:304-482-5573
Mailing Address - Fax:
Practice Address - Street 1:723 SUMMERS ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-6022
Practice Address - Country:US
Practice Address - Phone:304-428-5573
Practice Address - Fax:304-428-7784
Is Sole Proprietor?:No
Enumeration Date:2010-09-11
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV64309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily