Individual ProviderStacy WilsonRegistered NurseNursing Service ProvidersPractice Address1503 Givan Ave, Bronx, NY 10469-2755(347) 332-9141PECOS EnrollmentBased on the most recent information from CMS, provider Stacy Wilson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1134935281Provider TypeIndividualFull NameWilson, StacyGenderFemaleSole ProprietorYesEnumeration Date12/4/2024Last Updated12/4/2024Contact InformationPractice LocationPractice Address1503 Givan Ave, Bronx, NY 10469-2755Phone(347) 332-9141FaxUnlisted FaxMailing LocationMailing Address1503 Givan Ave, Bronx, NY 10469-2755PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense844395New York