Provider Demographics
NPI:1952021206
Name:PEREZ, STACY CAMERON (APRN FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:CAMERON
Last Name:PEREZ
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:MS
Other - First Name:STACY
Other - Middle Name:MICHELLE
Other - Last Name:CAMERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10250 NORMANDY BLVD UNIT 703
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-8063
Mailing Address - Country:US
Mailing Address - Phone:904-495-7200
Mailing Address - Fax:
Practice Address - Street 1:10250 NORMANDY BLVD UNIT 703
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-8063
Practice Address - Country:US
Practice Address - Phone:904-495-7200
Practice Address - Fax:904-495-7185
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily