Individual
STACEY ECKENROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1845 CAMPBELL AVE, PRESCOTT, AZ 86301-1211
(928) 717-3276
Mailing address
303 E GURLEY ST # 200, PRESCOTT, AZ 86301-3804
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
271623
AZ
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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