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MS. STACY RAE KISELJACK ARNP
NPI 1356300578
Nurse Practitioner in Jacksonville, FL

Active since March 17, 2006
1443 SAN MARCO BLVD, UFJP PEDIATRIC CARDIOVASCULAR CENTER, JACKSONVILLE, FL 32207(904) 306-3962(904) 493-2363 Get Directions Write a Review

NPPES record last updated: October 21, 2010. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Ms. Stacy Rae Kiseljack Arnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. STACY RAE KISELJACK ARNP (NPI 1356300578) is an individual nurse practitioner in Jacksonville, Florida, licensed in Florida (ARNP2744942) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1356300578
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMS. STACY RAE KISELJACKCredential: ARNP
Location Address1443 SAN MARCO BLVD, UFJP PEDIATRIC CARDIOVASCULAR CENTERJacksonville, FL 32207-8565
Mailing AddressPo Box 44008, Ufjp Provider EnrollmentJacksonville, FL 32231-4008 · (904) 244-3199 · Fax (904) 244-3425
Phone(904) 306-3962
Fax(904) 493-2363
Sole ProprietorNo
Enumeration DateMarch 17, 2006
Last NPPES UpdateOctober 21, 2010
✔ NPI 1356300578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in FL · ARNP2744942
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1443 SAN MARCO BLVD, Jacksonville, FL 32207
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Other Identifiers 5

Medicare UPINP46529FL
Medicare PINE6635YFL
Medicare PIN500021964FL
Medicaid3040267-00FL
Medicare PINE6635ZFL

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Kiseljack's NPI number?

The NPI number for Stacy Kiseljack is 1356300578. It was assigned to this individual provider in the NPPES registry on March 17, 2006.

Where is Stacy Kiseljack located?

Stacy Kiseljack practices at 1443 San Marco Blvd Ufjp Pediatric Cardiovascular Center, Jacksonville, FL 32207. The listed phone number is (904) 306-3962.

What is Stacy Kiseljack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Stacy Kiseljack was last updated on October 21, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.