Stacey Glass Malstrom
Nurse Practitioner
55 Whitcher St Ne Ste 350
Marietta
, Georgia 30060-1129
Stacey Glass Malstrom
Nurse Practitioner
55 Whitcher St Ne Ste 350
Marietta
, Georgia 30060-1129
(770) 424-6893
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Stacey Glass Malstrom
- 55 Whitcher St Ne Ste 350
- Marietta, GA
- Zip : 30060-1129
- Phone : (770) 424-6893
Second Address
- Stacey Glass Malstrom
- 55 Whitcher St Ne Ste 350
- Marietta, GA
- Zip : 30060-1129
- Phone : (770) 424-6893
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN177773 | GA |
National Provider Identifier
| NPI | 1003223934 |
|---|---|
| Provider Name | Stacey Glass Malstrom |
| First Address | Marietta, GA 30060-1129 |
| Second Address | Marietta, GA 30060-1129 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/07/2014 |
| Last Update Date | 16/07/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.