Provider Demographics
NPI:1730682873
Name:NORTON, STACY NICOLE JUDE (RN)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:NICOLE JUDE
Last Name:NORTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:NICOLE JUDE
Other - Last Name:ESPOSITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:14 SLOSSON TER
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 SLOSSON TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2507
Practice Address - Country:US
Practice Address - Phone:718-273-8409
Practice Address - Fax:718-273-5265
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY587042163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition Support