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

Stacy Graham

Individual provider Family Nurse Practitioner · NPI 1245699024

Stacy Graham is a Nurse Practitioner in Maumelle, Arkansas. Qualified in 2015, 11 years ago. Practices with Benny J Green MD PA, a 2-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
11
Licensed in
AR
In the registry since
2016
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Practice location Address checks out

17 Saint Thomas Dr
Maumelle, AR 72113-7003
Phone: (501) 912-2362
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence A004680 (AR)

Record details

NPI number1245699024
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 22, 2016
Last updated in NPPESFebruary 22, 2016
Mailing address17 Saint Thomas Dr, Maumelle, AR 72113-7003

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Benny J Green Md Pa — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Maumelle