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

Stacey Lynn Childress, AGPCNP

Individual provider Adult Health Nurse Practitioner · NPI 1083018030

Stacey Lynn Childress, AGPCNP is a Nurse Practitioner in Charleston, South Carolina. Qualified in 2014, 12 years ago. Practices with Pruitthealth Hospice Inc, a 40-clinician group. Licensed in South Carolina.

Years since qualifying
12
Licensed in
SC
In the registry since
2014

Practice location Address checks out

316 Calhoun St
Charleston, SC 29401-1113
Phone: (843) 724-2450
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 23153 (SC)

Record details

NPI number1083018030
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGPCNP
Sole proprietorNo
NPI enumeratedOctober 20, 2014
Last updated in NPPESMay 31, 2022
Certification dateMay 31, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Pruitthealth Hospice Inc — 40 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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