Individual
MS. MIRIAM JEAN STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
800 N APACHE AVE, WINSLOW, AZ 86047-3819
(928) 288-8108
Mailing address
800 N APACHE AVE, WINSLOW, AZ 86047-3819
(928) 288-8108
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN136305
AZ
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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