Individual
STACY LEIFRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 N GREEN VALLEY PKWY STE 239, HENDERSON, NV 89074-7704
(702) 844-4841
Mailing address
2370 CORPORATE CIR STE 300, HENDERSON, NV 89074-7760
(702) 910-3950
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN17354
NV
363L00000X
Nurse Practitioner
APRN00419
NV
363LF0000X
Family Nurse Practitioner
Primary
APRN00419
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265490585
—
NV
01
—
APRN00419
NSBN LICENSE
NV
Enumeration date
05/03/2006
Last updated
08/02/2024
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