Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Stacie K Grantham, CFNP

Individual provider Family Nurse Practitioner · NPI 1215175278

Mrs. Stacie K Grantham, CFNP is a Nurse Practitioner in Jackson, Tennessee. Qualified in 2008, 18 years ago. Practices with Total Extended Care Services PC, a 30-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
18
Licensed in
TN
In the registry since
2009
Specialties on file
3
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Practice location Address checks out

587 Skyline Dr
Jackson, TN 38301-3938
Phone: (731) 424-8922
Fax: (731) 423-2922
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence APN13513 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 13513 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence APN13513 (TN)

Record details

NPI number1215175278
Entity typeIndividual (Type 1)
GenderFemale
Credentials CFNP
Sole proprietorNo
NPI enumeratedJanuary 29, 2009
Last updated in NPPESSeptember 7, 2021
Certification dateAugust 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Total Extended Care Services Pc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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