Basic Information
| Provider Information | |||||||||
| NPI: | 1306170386 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BLAND | ||||||||
| FirstName: | STACIE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | APRN, DNP, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2013 CENTRAL RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708073918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257741120 | ||||||||
| FaxNumber: | 2257741158 | ||||||||
| Practice Location | |||||||||
| Address1: | 2013 CENTRAL RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708073918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257741120 | ||||||||
| FaxNumber: | 2257741158 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2009 | ||||||||
| LastUpdateDate: | 10/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP05791 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.