Individual
STACIE LYNNE RIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6795 EDMOND ST, SUITE 210, LAS VEGAS, NV 89118-3505
(702) 524-2928
Mailing address
PO BOX 370549, LAS VEGAS, NV 89137-0549
(702) 524-2928
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
5243
NV
Other
Enumeration date
03/08/2008
Last updated
03/08/2008
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