Provider Demographics
NPI:1366940322
Name:ALEXANDER, STACEY ANN (MSN, RN, CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:ANN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MSN, RN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28714 PLEASANT CREEK CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1540
Mailing Address - Country:US
Mailing Address - Phone:361-813-8721
Mailing Address - Fax:
Practice Address - Street 1:5039 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3114
Practice Address - Country:US
Practice Address - Phone:281-453-7169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX765470163W00000X
TXAP135523363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse