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

Stacey Marie Tallo

Individual provider Family Nurse Practitioner · NPI 1659151157

Stacey Marie Tallo is a Nurse Practitioner in Georgetown, South Carolina. Qualified in 2023, 3 years ago. Practices with Novant Health Urgent Cares LLC, a 184-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
3
Licensed in
SC
In the registry since
2023

Practice location Address checks out

1068 N Fraser St
Georgetown, SC 29440-2849
Phone: (843) 545-7200
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 28666 (SC)

Record details

NPI number1659151157
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 2, 2023
Last updated in NPPESJanuary 8, 2025
Certification dateJanuary 8, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Novant Health Urgent Cares Llc — 184 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Georgetown