Provider Demographics
NPI:1164250767
Name:FOLEY, STACY E (APRN)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:E
Last Name:FOLEY
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 1:7025 8TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-9793
Mailing Address - Country:US
Mailing Address - Phone:772-559-9592
Mailing Address - Fax:
Practice Address - Street 1:1220 N HIGHWAY A1A STE 147
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-2858
Practice Address - Country:US
Practice Address - Phone:321-253-7547
Practice Address - Fax:321-951-9127
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034979363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2576OtherHFMG