Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stacey Jantzen, AGACNP-BC

Individual provider Nurse Practitioner · NPI 1760056527

Stacey Jantzen, AGACNP-BC is a Nurse Practitioner in Mansfield, Texas. Qualified in 2013, 13 years ago. Practices with Clinical Care in Radiology, a 16-clinician group. Licensed in Texas.

Years since qualifying
13
Licensed in
TX
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

2700 E Broad St
Mansfield, TX 76063-5899
Phone: (682) 242-6440
Fax: (682) 242-6445
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1017499 (TX)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 1017499 (TX)

Record details

NPI number1760056527
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedMay 17, 2021
Last updated in NPPESAugust 9, 2021
Certification dateAugust 9, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Clinical Care In Radiology — 16 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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