Individual
STACI MARIE GRABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5203 WILLOW CREEK DR. STE 203, SPRINGDALE, AR 72762
(479) 757-8001
(479) 750-0571
Mailing address
5501 WILLOW CREEK DR. STE 203, SPRINGDALE, AR 72762
(479) 575-9359
(479) 575-9415
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
A001929
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167760758
—
AR
Enumeration date
05/17/2007
Last updated
07/21/2022
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