Individual
STACY ANN MARIE THALER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
181 E KIMBERLY DR, HENDERSON, NV 89015-7904
(702) 306-0516
Mailing address
181 E KIMBERLY DR, HENDERSON, NV 89015-7904
(702) 306-0516
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
813726
NV
363LA2100X
Acute Care Nurse Practitioner
813726
NV
363LG0600X
Gerontology Nurse Practitioner
Primary
813726
NV
Other
Enumeration date
08/13/2025
Last updated
10/02/2025
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