Individual
STACIE LEA LONGMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPRSS
Contact information
Practice address
855 MILL ST STE 1A, RENO, NV 89502-1499
(775) 501-8655
Mailing address
3035 S MARYLAND PKWY, LAS VEGAS, NV 89109-2200
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PRSS-5287
NV
Other
Enumeration date
10/15/2025
Last updated
10/24/2025
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