Individual
STACY ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5555 ZUNI RD SE STE 11, ALBUQUERQUE, NM 87108-2935
(505) 777-3002
Mailing address
PO BOX 740018, ATLANTA, GA 30374-0018
(505) 777-3002
(505) 521-5189
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
67604
NM
363LF0000X
Family Nurse Practitioner
AP3006906
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44609736
—
NM
05
—
936057
—
AZ
Enumeration date
10/24/2006
Last updated
03/12/2026
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