Provider Demographics
NPI:1689429177
Name:BISIGNANO, STACY (NP)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:BISIGNANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16497 GAINESWOOD DR N
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-5055
Mailing Address - Country:US
Mailing Address - Phone:901-351-7319
Mailing Address - Fax:
Practice Address - Street 1:16497 GAINESWOOD DR N
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-5055
Practice Address - Country:US
Practice Address - Phone:901-351-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-141537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily